Metabolic Syndrome and Pre-Diabetic States - Cardiometabolic Syndrome

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Metabolic Syndrome has been well established as one of the most significant health threats to the overall population since late 1970s, but in the United States, there has been little public education of this disorder, and a stubborn refusal by the medical establishment to separate it from the concept of Diabetes itself. For a number of years, diabetes has been a growing problem in the United States, and the explosive growth of this disease state has been called Diabetes Type II and the pre-Diabetic state, accounting for over 90 percent of all cases of diagnosed, or misdiagnosed, diabetes. Diabetes is a disease defined by an inability to regulate blood sugar, or glucose, and is characterized by frequent or profuse urination and increased thirst, hyperglycemia (high circulating blood sugar), deficient insulin production from pancreatic beta cells, and dyslipidemia (unhealthy lipid metabolism). Metabolic Syndrome, on the other hand, is a still poorly understood syndrome with insulin resistance, higher insulin need, fatty liver disease, and chronic low-grade inflammation creating a cycle of dysfunction, obesity and cardiometabolic risk. Many experts have noted that the differences between Metabolic Syndrome and Type 2 Diabetes are much greater than the similarities and have called for a better classification of these disease states, but there has been little progress in defining them better to improve and individualize treatment protocols. There is no one-size-fits-all approach to treating diabetes and Metabolic Syndrome, and we should quit pretending there is.

The U.S. Center for Disease Control (CDC) in 2013 estimated that about 12 percent of the U.S. population age 0 to 44, and 21.8 percent of the population age 45-64, has been diagnosed with Diabetes, and and at least another 3 percent are still undiagnosed. Over 93 percent of these patients have what is termed Diabetes Type II, though, which is still not clearly distinguished from Metabolic Syndrome. To learn more about Diabetes Mellitus, go to the article on this subject on this website. In 2013, the Journal of the American College of Cardiology published a study by experts at Harvard University and the University of Pennsylvania, that stated that Metabolic Syndrome was evident in 25.5 percent of the U.S. population in 1999-2000, and lowered a little to 22.9 percent of the population in 2009-2010, reflecting changes in diet and lifestyle with public education. These statistics are alarming, though, and these experts stated that this analysis "highlights the urgency of addressing abdominal obesity as a healthcare priority". The experts stated that about a fifth of the adult population remains at high cardiometabolic risk, and particular subsets, including white males and non-white females, and Hispanics of both sexes, had higher incidence of abdominal obesity and low HDL-cholesterol, high triglycerides and high random blood glucose, the main markers of Metabolic Syndrome (Hiram Beltran-Sanchez et al, JACC Aug 2013; Vol 62 (3) 697-703). A number of research studies, though, have shown that the emphasis on abdominal weight loss is misdirected, as the fundamental problem in Metabolic Syndrome is fatty accumulation in the organ tissues, especially the liver and pancreas/spleen. When Metabolic Syndrome occurs, insulin resistance and hormonal imbalance inhibits weight loss, though, and to truly reverse this dangerous syndrome, a more holistic protocol needs to be adopted. A one-size-fits-all pharmaceutical treatment protocol has not worked and the enormous rise in incidence of Metabolic Syndrome, obesity and diabetes in the United States since 1980 shows that we should have integrated Complementary Medicine and a more holistic patient-centered approach long ago. There is obviously a difference between classic diabetes with thirsting and wasting and Metabolic Syndrome with obesity, and the failure to recognize this and develop better treatment and prevention strategies is a failure of standard medicine and public health.

In 2013, research headed by Dr. Roy Taylor, a professor at Newcastle University, in the United Kingdom, showed that Metabolic Syndrome, or Diabetic Type 2, or the prediabetic state, depending on what one wants to call it, is reversible with dietary approaches alone. This research culminated in an initial small human clinical trial published in 2016 that showed that 50 percent of patients put on a low calorie diet of 3 healthy shakes per day and non-starchy vegetables for just 8 weeks, and then kept on a healthy diet, avoiding processed foods, sugars, and predominantly plant-based with fresh healthy foods, were cured of Metabolic Syndrome or Diabetes Type 2, maintaining normal circulating blood sugar levels. Dr. Taylor's research showed that the definitive early sign of Metabolic Syndrome, insulin resistance throughout the body, is able to be reversed when fatty liver and slightly elevated triglycerides are resolved, and that fatty accumulation and loss of beta cells in the pancreas, largely attributed to free fatty acid metabolites and environmental factors, is also a key component in this Metabolic Syndrome and can also be reversed, without any medication, and leaving the patient without any dependency on medication. This remarkable study finally was performed and proved that the key to treatment of this devastating public health problem is a holistic approach with diet, lifestyle, exercise and of course, Complementary and Integrative Medicine (CIM/TCM) which is still avoided in mention in standard medicine, or taboo. The patients in this study showed modest weight loss, less than 30 pounds in obese patients, also showing that the amount of weight loss is not the key to health and cure, but attention to normalizing metabolic homeostasis is. With a more comprehensive protocol we might be able to see much more than a 50 percent success rate. This initial small study is already being followed up with plans for a second larger stage 2 study, entitled Diabetes Remission Clinical Trial (DIRECT), and we can only hope that industry lobbying and pressure will not reverse this amazing finding and enactment of the cure for Metabolic Syndrome. 

In 2016, experts at this Newcastle University in the U.K. along with the Vrjie University School of Medicine, in Amsterdam, released the findings of a large study of the relationship between sleep duration and onset of Metabolic Syndromes, with insulin sensitivity, insulin resistance and pancreatic beta cell function analyzed. This study, perhaps the first of its kind, showed that in men that deviation from the average hours of sleep, now set at 7 hours per night, both decreased or increased from the 7 hours, had a significant association with onset of Metabolic Syndrome, while in women, the deviation from the norm of 7 hours with either less of more sleep had an inverse association. Obviously, this did not determine that we need to have a set number of hours of sleep, as is often touted in healthcare, but that with men, trouble achieving the recommended number of hours led to factors that could affect the metabolism. The authors of this study noted that they did not include the use of sleep medication, measure the quality of sleep, or record incidence of sleep apnea in this study, which is much more prevalent for men than women, and noted that slow-wave sleep (SWS) is decreased in sleep apnea, leading to poor quality sleep. Sleep apnea and Metabolic Syndrome are highly associated as well. The authors noted that women have a phase-advanced circadian metabolism that is less prone to disturbance of the circadian rhythm, a key factor in regulation of insulin sensitivity. Sleep medications have been shown to affect men and women differently as well, with the popular drug Ambien (zolpidem) shown to metabolize more efficiently in men than women, creating a faster and greater effect, but leaving women with more of the drug in their system the next morning. Ambien use is thus probably higher in men than women, and may be negatively affecting the sleep cycle and quality of sleep that explains the adverse effects in men who have difficulty with achieving the desired number of hours of sleep. Medication habits associated with sleep disturbance and insomnia may be a significant factor, as there is a clear association between use of atypical antipsychotics, often prescribed off-label, with Metabolic Syndrome, obesity and diabetes, as well as several other types of psychotropic drugs. Ambien, or zolpidem, is strongly associated with disturbance of the sleep cycle, causing sleep walking and other sleep behaviors in a significant percentage of patients. Achieving healthy sleep quality rather than a focus on quantity is clearly becoming the dominant theme in the study of the implications of insomnia, but so far has not fit in well with the dominant philosophy on standard treatment. Complementary and Integrative Medicine and TCM clearly presents an holistic protocol to improve sleep quality and decrease the use of sleep medication and its adverse health effects.

With an estimated 15 percent of the total U.S. population potentially afflicted by diabetes, and 25 percent with Metabolic Syndrome, and the longstanding realization that different forms of this diagnostic classification are distinctly different in cause and pathological mechanisms, there is a need to better define these various manifestations of the disease through clearer classification in diagnosis. For instance, the terms Diabetes Mellitus, Insulin Resistant Diabetes, Metabolic Diabetes, and Metabolic Syndrome could be used to help patients better understand their health problem, and to clarify treatment strategies. This is important because the one-size-fits-all treatment strategy in diabetes and Metabolic Syndrome, or pre-diabetes, is now proven to cause problems. A 2010 study published in the medical journal The Lancet revealed that a meta-review of over 91,000 patients in randomized controlled human clinical trials showed that patients with Metabolic Syndrome treated with statin drugs to lower lipid cholesterol had a 9 percent increase in the risk of developing true diabetes because use of statins increased insulin levels (Sattar, Preiss, Murray et al; Lancet 375(9716) 735-42). In the last decade we in fact found that standard treatment for Metabolic Syndrome led to the onset of actual diabetes, with the routine prescription of statin drugs to lower LDL-cholesterol increasing the risk of progressing to true diabetes by 46 percent, according to a 2015 Finnish study, and this is unacceptable. We have also found that newer pharmaceutical drugs to treat Metabolic Syndrome and diabetes actually increased cardiovascular risk, and that none of these drug strategies reverse the underlying health problems that create this dangerous cycle of metabolic dysfunction. A new approach is desperately needed. As far back as 2006, warnings that a number of medications may directly or indirectly increase the risk of developing a Metabolic Syndrome were largely ignored. To see such a warning by the University of Mississippi School of Medicine, click here: . Medications such as antipysychotics, antidepressants, blood pressure medications (beta-blockers and diuretics), and corticosteroids, as well as statins, are linked to increased risk of Metabolic Syndrome.

Research has shown that lipid balance and healthier metabolism of lipid cholesterol can be achieved by using diet and lifestyle changes, as well as herbal and nutrient medicine and acupuncture, and that this Complementary and Integrative Medicine (CIM) protocol would reduce the insulin need, not increase insulin in circulation, which leads to Insulin Resistant Diabetes. With the now numerous warnings of increased cardiovascular risk, hormonal changes, weight gain and even cancer risk from diabetic medications, using these medications to treat Metabolic Syndrome, Metabolic Diabetes, and Insulin Resistant Diabetes when safer protocols exist is not sensible. Widespread adoption of Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) would achieve better outcomes for millions of patients, and patient demand may be the only thing that finally pushes this change in our medical system.

What actually separates Metabolic Syndrome from Diabetes Mellitus? Problems of insulin deficiency versus insulin excess, the classifications of disease versus a syndrome of dysfunctions, and the problems associated with insulin resistance at the cellular receptors rather than the dysfunction of the beta cells of the pancreas are the key factors in distinguishing true diabetes from Metabolic Syndrome. Diabetics are divided into insulin-dependent and non-insulin-dependent patients when treating. Insulin-dependent patients must manage the inability of the pancreas to produce insulin by injecting synthetic insulin in dosages that relate to the monitored blood sugar. Although insulin injections will help the patient to manage the circulating blood sugar levels and sugar metabolism, this does not correct all aspects of an unhealthy metabolic state, and often there is both a diabetic state and a Metabolic Syndrome seen in these patients. The treatment must be broader than just insulin use to restore health. Non-insulin-dependent patients are given a variety of drugs to help normalize sugar metabolism, as well as to protect against cardiovascular risk, and manage lipid dysfunction, and their care is not clearly distinguished from the management of Metabolic Syndrome. Patients with Metabolic Syndrome, which is not diabetes, and may not actually be a pre-diabetic state for many patients, are routinely told that they have diabetes, and are not informed concerning the need to reduce oxidant and inflammatory stress and fatty accumulation in the liver. To address the treatment and prevention needs in Metabolic Syndrome and insulin resistant states, there is no help from standard pharmaceutical treatments, and Complementary and Integrative Medicine, and especially Traditional Chinese Medicine (CIM/TCM) provides patients with the needed therapeutic tools.

There is an overlap, obviously, with diabetes and metabolic syndrome, but these disease mechanisms are increasingly distinguished from one another as research progresses. This failure to clearly define the disease and distinguish it from the syndrome presents an alarming and confusing state for the patients, and does not help them to make decisions concerning a proper course of care. The standard course of care with pharmaceuticals, which often involves prescribing the same five drugs to every patient regardless of the individual parameters of the disease or syndrome, is obviously inadequate to decrease the incidence of Diabetes Type II and Metabolic Syndrome, as the incidence of these disease syndromes is rising very fast in recent years. This is where Integrative and Complementary Medicine can come into play, as well as changes in public health, patient education, and regulation of the food industry.

Metabolic syndrome is defined by a group of signs and symptoms, including high blood pressure, elevated insulin levels, abnormal cholesterol, or lipoprotein, levels, and excess body fat around the midsection, due to insulin resistance and inability to burn this fat. It is estimated that more than 25 percent of the population could be diagnosed with Metabolic syndrome, and an alarming incidence in our children is causing much concern, associated with excess antibiotic use in infancy, childhood obesity, too little physical activity, and increased sugar intake. The standard strategy for dietary prevention of Metabolic Syndrome, just substituting the sugar with synthesized sugar substitutes, such as Aspartame and Saccharin, has now been proven to itself cause Metabolic Syndrome and obesity, apparently because of the effects of these chemicals on the human Biome. Obesity, or abnormal fatty deposition, now affects one third to one half of the population in the United States, and is not easily reversed, because of the complex metabolic dysfunction that has occurred. The term Metabolic Syndrome was already in use by the medical establishment in 1977, when Herman Haller M.D., a Dean of Medical Education at Hanover Medical School, in Germany, published a paper in a medical journal describing Metabolic Syndrome as obesity, diabetes mellitus, hyperlipoproteinemia (high LDL), hyperuricemia (high uric acid excretion), and steatosis hepatitis (commonly referred to a fatty liver). Since then, the diagnosis has been debated and refined, and Diabetes Mellitus is no longer a significant part of the syndrome, although it may be related. Progression from Metabolic Syndrome to Type 2 Diabetes occurs in a subset of these patients, and apparently involves early cell death, or apoptosis, of up to half of the pancreatic Beta cells that produce insulin, and consequently, an increased stress on the remaining Beta cells to produce high levels of insulin in an insulin resistant body. This is highly linked to oxidative stress and free fatty acids, with metabolites causing an increase in the ceramides within the pancreatic cells, which play a strong role in regulating cell apoptosis, or normal cell lifespan.

It appears that the focal problem in Metabolic Syndrome is the phenomenon of the fatty liver, or hepatic steatosis, still called non-alcoholic fatty liver disease, because for decades fatty tissue accumulation was attributed to excess alcohol intake in almost all cases. We now know that a number of factors cause fatty liver in the absence of alcohol intake. The most common food additives in the last decades, high fructose corn syrup and transfats, are both highly linked, but we are finding that other factors are important too. For instance, a 2016 review of such studies by the University of Toronto School of Medicine, and the University of Medicine and Pharmacy Carol Davila, in Romania, found that excess generation of oxidants and gut-derived bacterial endotoxins are integral to the pathology, causing injury to liver cells and a response of key inflammatory cytokines, with impaired regeneration of new tissues, fibrogenesis and cirrhosis, or hardening of the liver tissues (PMID: 27096691). Obviously, the role of a healthy gut Biome is important in the slow reversal of fatty liver disease, and the use of antioxidants and clearing of low-grade pathological microbial overgrowth and endotoxins with herbal formulas, as well as the reversal of the dietary stress on the liver, stimulation of liver growth and function with acupuncture,

Guidelines for diagnosis of Metabolic Syndrome in recent years suggested that the patient must meet 3 of 5 diagnostic factors: 1) difficulty losing weight and large waist size, 2) blood sugars sustained at greater than 110, 3) triglycerides sustained at greater than 150, 4) HDL sustained at less than 50 for women, and less than 40 for men, and 5) high blood pressure sustained at greater than 130/90. Often, the quick diagnosis of diabetes is made without even testing these 5 most basic signs of Metabolic Syndrome. An elevated fasting blood sugar alone is not enough to clearly diagnose diabetes, and the treatment protocol for Metabolic Syndrome is much different than that for true diabetes. The complexity of the metabolic syndrome, and its treatment, is overwhelming to many patients, and understanding of metabolic dysfunction is very important to the patient when choices need to be made to correct this metabolic dysfunction and achieve a healthy state again. The consequences of metabolic syndrome include a long list of increased risks for serious diseases, especially stroke, as well as diminished quality of life.

Metabolic Syndrome is the most prevalent health threat in our population today, and although this syndrome is variable between patients and difficult to understand, it does address the core of your health and the need for a holistic and thorough approach to patient understanding and action. Treatment for Metabolic Syndrome and cardiometabolic risk demands a more thorough and holistic approach, and standard medicine has failed to prevent or reverse this alarming health crisis, now also associated with cancer and dementia.

Metabolic disorder is a health problem that is not isolated to a particular organ or mechanism in the body, and does not have one particular cause. In fact, recent research in Japan has shown that metabolic syndrome is even variable with the seasons. At the University of Occupational and Environmental Health School of Medicine in Naka-gun, Japan, 1202 male workers were monitored and blood serum levels of glucose and HDL, and blood pressure, were all significantly higher in winter than in summer, while triglyceride and waist circumference did not vary significantly. Seasonal variation of metabolic health problems is a topic that was integral to the physicians practicing Traditional Chinese Medicine, or holistic health, and reveals that metabolic health balance is indeed a complex multifactorial health problem. The effects of seasonal variance on individual health problems is discussed extensively in the earliest complete medical text of TCM, the Nei Jing de Huang Di. These new statistics show that more patients would be diagnosed and prescribed a variety of prescription medications if they had their exam and check-up in winter than in summer. A thoughtful individualized diagnosis and treatment strategy is needed for this complex health problem, and integration of Complementary Medicine into the overall treatment protocol is becoming the hallmark of such a patient centered approach. Working toward improved health of the metabolism involves an interdisciplinary approach and multifactorial focus, which is a hallmark of holistic medicine and TCM science. A public health approach and effective preventative strategy also desperately needs to be implemented. China was the first country in history to adopt a significant public health preventative approach to health problems at the urging of holistic physicians.

Defining Metabolism and Metabolic Syndrome

Metabolism is the sum of chemical and physical changes that occur in tissue to maintain life. We generally think of metabolic changes as chemical breakdown, or catabolism, and chemical construction, or anabolism. These terms may also be applied to the breakdown of aging tissues, and the rebuilding of new healthy tissues. Of course, catabolic and anabolic processes need to be balanced to maintain health, since the body uses the products of chemical and physical deconstruction to supply it with the raw materials for construction of new chemicals and tissues. The hormone insulin is an anabolic hormone and is integral to the metabolic homeostatic balance our bodies try to maintain. In Traditional Chinese Medicine (CIM/TCM), this is an example of Yin and Yang balancing. Yin Qi refers to the process of constructing chemicals and tissues, and Yang Qi refers to the utilization of these chemicals and tissues to power the body. Physicians in ancient China that studied this holistic medicine that we now call TCM realized the need for metabolic balance to maintain optimal health, and centuries of therapeutic protocol are designed to achieve this goal. Science is discovering that many common health problems have at their core an imbalance between the anabolic and catabolic processes in the body, leading to degeneration of cells and tissues. Improving metabolic function may be the most important preventative measure that the patient could take today. Of course, restoration of a healthy metabolism takes an holistic approach with sensible diet and lifestyle regimens enhanced by therapeutic tools. This emphasis on an holistic approach is also a hallmark of CIM/TCM, and short courses of acupuncture, with a step-by-step approach with herbal and nutrient medicine, are meant to support the healthy proactive efforts by the patient to correct metabolic dysfunction.

The rate of metabolism is largely controlled by protein enzymes and hormones. Protein enzymes are catalysts for specific cellular reactions, and allow the chemical construction or deconstruction to occur at very accelerated rates by increasing the energy efficiency. Our genes express proteins, and protein enzymes are created in response to metabolic needs for chemicals and cellular molecules. Many enzymes are created in the liver, but all cells also create enzymes within an elaborate feedback mechanism. Hormones are simple molecules that do not have actions of their own, but rather stimulate receptors to control metabolic processes, and insulin, cortisol, estrogen and testosterone are just some of the wide array of hormones that our body creates, transforms, and utilizes to control metabolism. These hormonal processes are constantly in motion and act in concert, in a sort of quantum field of reactions within the endocrine system. Hormone production and secretion, called endocrine activity, is tightly regulated in a feedback system that involves organs and tissues spread throughout the body. These two factors, liver metabolism and endocrine feedback regulation, are the key to homeostatic metabolic regulation, but are just a small part of the complicated human metabolic physiology. One can see from this simplified description that metabolism is very complex in its interactions, and needs a complex balance in the body to function properly, including healthy raw materials.

While metabolism occurs in all cells of our body, the busiest metabolic organ is the liver. Most of the tissues and molecules of the body are composed of three basic classes of molecule, the amino acids (protein), carbohydrates (sugars) and lipids (fats). The liver both constructs and deconstructs many of these amino acids, carbs and lipids, and also converts one form to another, especially to create fuel for these processes in the form of glucose. Glucose provides much energy in our body, but is not stored as glucose, and conversion to triglycerides and the ability to utilize these stored triglycerides is very important for the human energy needs. Energy stores are largely in the form of lipids and proteins, and lipoproteins carry these molecules to the fat cells in our body to store them, and then carry them back to the liver to convert them as needed. Low density lipoproteins (LDL) generally carry the molecules out to the cells, and high density lipoproteins (HDL) generally carry the molecules back to the liver. A deficiency of these HDL carrying the hormone cholesterol and other important chemicals back to the liver is a hallmark of Metabolic Syndrome.The persistence of medical doctors to simply tell their patients that they have high cholesterol, and not educate the patient to the importance of the balance of lipoprotein types that carry cholesterol back and forth to the liver, is an alarming failure in standard medicine to improve outcomes by educating patients.

A balance is of course needed in our metabolism between LDL and HDL, and this is one of the most important laboratory values to analyze in metabolic syndromes. the LDLc/HDLc ratio, which is now translated at the total lipid cholesterol over the high density lipoprotein cholesterol. If the ratio is too high, meaning the HDLc is too low, this is the clearly one of the most dramatic risk factors for heart and cardiovascular disease, along with high triglycerides. Triglycerides are essentially fatty acids combined with glycerol. Both of these lipids, or fats, can be converted to glucose in the liver, and this process is continuous. Triglycerides are the form of stored energy that is primary in our fat cells. Levels of triglycerides in circulation are also an important indicator of the healthy function of the liver, reflecting the rate of liver metabolism, along with the liver enzymes (ALT, AST, SGOT, SGPT) that convert one amino acid to another to form needed proteins and enzymes. High triglycerides and liver enzymes imply that the liver function is slow, possibly due to chronic inflammation, fatty accumulation, or cellular damage from disease. High levels of free fatty acids, triglycerides, and HDLc also occur when there is a problem with fat cell metabolism, which has been overlooked in this equation greatly. Another marker, the C-reactive protein (CRP), indicates that the liver is struggling to keep up with inflammatory regulation, which is integral in the pathophysiology of Metabolic Syndrome. All of these markers of Metabolic Syndrome indicate a potential problem in both the liver and the broad adipose organ. None of these factors has a direct relationship to pancreatic function, though, the seat of diabetic pathology.

Optimal health and function of the liver and kidney are absolutely essential to metabolic health. Many factors outside of the body contribute to increased physiological stress on the liver and kidney functions. Chief among these are heavy consumption of chemicals that are not natural to normal function, and increases on energy and metabolic demands from chronic inflammatory dysfunction. The liver is the main detoxifier in the body, and the main creator of inflammatory mediators. The current strategy in standard medicine regarding metabolic syndromes is to give the patient 3-6 types of prescription medications to cover the various metabolic concerns. The failure to see that loading the patient with complex chemical prescriptions itself presents a harsh load on liver and kidney function and threatens to worsen metabolic dysfunction is the chief blind spot in medicine today. Many medical doctors are now realizing that this strategy chiefly benefits the bottom line of the pharmaceutical industry, and may not be the best strategy in public health for lowering the incidence of Metabolic Syndrome. Of course, high alcohol consumption, smoking, drug use, high coffee and soft drink consumption, advanced glycation endproducts (AGEs) in processed foods, transfats, preservatives, and a growing number of toxins and hormone-like chemicals in our environment, especially in products that we willingly buy and consume, are also posing significant metabolic stress threats. If one pays attention to food labels they will see that many products that do not taste sweet have as much processed sugar in them as our sweet foods today, and processed foods need to be avoided when correcting Metabolic Syndrome. As individuals, we need to both educate ourselves concerning metabolic health, and to urge our government to increase efforts in public health and regulation of the environment and food industry. The Licensed Acupuncturist and herbalist is often a person that can spend the time to help you understand your metabolic health and how to best restore balance and healthy function.

This holistic approach to reversing the complex cycle of dysfunction in Metabolic Syndrome must also address the fat cells, though, and chronic oxidant and inflammatory stress, and hormonal imbalance, creates a dysfunction at the fat cells, an important organ in the body, that involves insulin resistance. Biological hallmarks of insulin resistance at the fat cells includes an increased expression of enzyme proteins such as SIRT-1, as well as AGE receptors (RAGE or AGER-1), as well as serum GGT (gamma-glutamyltransferase) and ferritin (iron storage). A broad holistic approach is needed to achieve success in prevention and treatment of Metabolic Syndrome. Short courses of acupuncture, with persistent herbal and nutrient therapy individualized for each patient and taken in a step-by-step protocol, as well as sensible changes in diet and lifestyle guided by a professional, will eventually reverse Metabolic Syndrome, fatty liver and insulin resistance.

Understanding the Physiology in Diabetes and Metabolic Syndromes

It is important for the patient to understand the physiological differences between diabetes and metabolic syndrome. In diabetes, the deficiency or lack of insulin creates serious health problems for the metabolism, but in most metabolic syndromes, is is an excess of insulin driven by insulin resistance that creates the problems. This simple fact is still largely ignored by physicians, and this is largely because we are resistant to a change of terminology, and to a change in the focus of treatment.

To understand diabetes, let's first try to understand the pancreatic hormone insulin. Insulin, a regulatory protein, normally binds with fat cells, muscle fiber, and cells of the liver, causing not only increased transport of glucose into these cells, but also stimulating a cascade of enzyme activity that regulates storage and release of glucose. Insulin also plays a major role in fat metabolism, inhibiting the breakdown of triglycerides into fatty acids (causing a stubborn obesity). When insulin is not available, these fatty acids are released, and are abundant in the blood, attached to lipoproteins, and storage of these fats are blocked, leading to high cholesterol and athersclerosis. In addition, the excess fatty acids accumulating in insulin deficient states are converted to large quantities of acetoacetic acid, which leads to acidosis. Lastly, insulin promotes protein formation and inhibits protein breakdown, and the absence of insulin leads to lack of protein storage and availability, causing neurological problems and a hyperuremic state (excess protein in the blood and urine), as well as a host of other problems.

In contrast, what we usually see in Metabolic Syndrome is a high availability of insulin but poor insulin function. When the insulin doesn't function well, the types of symptoms are varied and your health suffers in many ways that can be indirectly linked to insulin dysfunction. The key to insulin dysfunction is a metabolic problem called insulin resistance, where the insulin hormone is not affecting the fat cells properly. When this occurs, the fat cells are not able to efficiently release fat for conversion to glucose in the liver. The fat cells become enlarged, and the patient is unable to lose weight. Inflammatory dysfunction in the fat cells has been found to be a key component in this process. Dysfunction of hormone receptors also plays a key role. Since all steroid hormones are very similar molecules, the receptors may respond in part to various hormones. Imbalances of other steroid hormones may play a significant role in this receptor dysfunction.

Both hormone imbalances and inflammatory dysfunction are tied to adrenal stress. Physiologically, stress is more than just the feeling of being stressed emotionally. It is the process of increased metabolic demands that are greater than your systems can handle. One key cause of this metabolic adrenal stress occurs when normal quantities of carbohydrates are not available in the body. When a person eats simple carbohydrates, such as sugar and bread, these convert quickly to glucose to fuel the body, but in a short time, there is a lack of new carbohydrates to form glucose. When this occurs, the pituitary gland secretes more corticotropin, which signals production of large quantities of the adrenal hormone cortisol, and other glucocorticoid hormones. Cortisol stimulates the extraction of proteins from all cells to provide amino acids to the liver to make more glucose. Since only about 60% of amino acids can be turned into glucose in the liver, this process can create enormous liver stress. High cortisol stimulation from poor bioavailability of carbohydrates, insulin resistance, and stress leads to protein depletion without burning fat, and this scenario can ultimately lead to hormonal and adrenal deficiency. Excess cortisol, cellular protein depletion, and liver stress also combine to create inflammatory dysfunction that leads to insulin resistance, creating a viscious cycle. Dirunal cortisol imbalance eventually creates insomnia, fatique, anxiety and depression. When the patient consumes complex carbohydrates, with a high glycemic index, the breakdown of the carbohydrates is slow and steady, and this episodic adrenal stress does not occur as easily.

While there may be a number of factors contributing to adrenal stress, we see from the above explanation the importance of changing your diet when you have insulin resistance and metabolic syndrome. Avoiding or decreasing sugary foods and baked goods, or flours, and increasing whole grains and honey may have a dramatic result. Excess intake of fruit also is a source of simple carbohydrates and should be avoided, such as consuming large doses of fruit juice in one setting. The way that we see that that the body is having a problem with steady glucose supply and subsequent liver stress, is that your blood tests show high triglycerides. Triglycerides are the intermediate molecule in the conversion of proteins to glucose, and also carry the fats and proteins in the cholesterol carrier, lipoproteins. A deficiency of high density lipoproteins, which carry these fuels for glucose back to the liver, inhibits this process further. When the liver is very stressed, the liver enzymes, or transanimases, GOT, SGOT, are also high on your blood tests. The pharmacuetical answer to these metabolic problems is to block genetic expression, or production, of these lipoproteins and triglycerides. Common sense tells us that this is not a healthy approach in the long run.

To summarize, insulin activity regulates sugar, fat, and protein metabolism in the body, all of which may be converted to glucose to meet the body's energy needs. In the absence of insulin great care must be taken to 1) regulate these metabolic balances by controlling the intake of carbohydrates, fats, and proteins, and 2) to regulate the utilization of these substances by increasing exercise when glucose levels are too high. If this is not done in an intelligent way, blood glucose levels are not maintained and cholesterol levels and subsequent cardiovascular disease becomes a real threat. In Metabolic Syndrome glucose binding must be enhanced, and if the patient is overweight, weight reduction is often the key to improvement of insulin sensitivity, (as well as the 2 steps described above), as insulin binding to fat cells is more difficult in the obese person. Obesity has been firmly linked to insulin resistance and chronic inflammatory states in the white fat cells. Dieting has not been successful in many cases, and when dieting is unsuccessful, hormonal correction and regulation of the inflammatory process is necessary to lose weight. Since insulin is a steroid hormone of the endocrine system, your hormonal and endocrine balance must be improved to achieve proper insulin function, endocrine balance and weight loss.

As Metabolic Syndrome progresses and fluctuating high circulating glucose and an imbalance of key hormonal regulators occurs (insulin, glucogan, leptin, adiponectin), we see a gradual loss of healthy insulin-secreting beta cells in the pancreas, and increased demand on the remaining beta cells to produce a higher level of circulating insulin in response to insulin resistance both in the muscle fat and the liver cells. This injury to the pancreatic beta cells involves a metabolic cycle of chronic low-grade inflammation, excess free fatty acids in circulation, and generation of metabolites of these free fatty acids, called ceramide, within the pancreatic cells. When metabolic dysfunction and fatty liver occurs, our immune system loses its homeostatic balance and cytokines such as Tumor Necrosis Factor (TNF-alpha) stimulate cytotoxic T cells, or lymphocytes, to express an excess of free fatty acids and ceramide. Added to this is the exogenous natural ceramide and both saturated and monounsaturated free fatty acids introduced by the diet, and released from apoptotic cells. While free fatty acids play a valuable role in insulin and glucose metabolism normally, excess free fatty acids are proven to damage pancreatic beta cells, both leading to a percentage of cells undergoing more rapid programmed cell death (apoptosis), and also hyper-stimulating surviving beta cells and increasing the ratio of proinsulin to insulin. To correct this problem, a number of strategies have to be used together, with improved inflammatory immune responses, better liver function, and improved diet. This excess of free fatty acids in blood circulation, namely palmitic acid, stearic acid and arachidonic acid, has also been shown to be associated with decreased kidney/adrenal function and lowered testosterone, attributed also to ceramide generation within adrenal Leydig cells. In Metabolic Syndrome and Type 2 Diabetes the rate of lipolysis (breakdown of fat cells) due to increased abdominal and organ fat is increased, leading to a chronic increase in free fatty acids, and this in turn leads to oxidative stress and increased free fatty acid oxidation. This process is called lipotoxicity. This cycle of dysfunction cannot be reversed by allopathic drugs alone.

Insulin binding and utilization is also a problem in diseases with abnormal fat distribution and cholesterol buildup. In AIDS patients taking protease inhibitors, fatty deposits will accumulate on the shoulders and neck, and trunk, and onset of diabetic symptoms often will follow. In hypothyroidism, Cushing's syndrome, and other endocrine disorders, fatty deposits will accumulate on the trunk and face and this will lead to a higher risk of diabetes onset. Study of these problems has led us to conclude that obesity in Metabolic Syndrome is linked to protein dysfunction and endocrine disorder. As stated, hormones are key to metabolic regulation, and are relatively simple molecules that easily transform one into another according to physiological need. Insulin is a steroid cholesterol-based hormone that is very similar to progesterone. Progesterone imbalance may have a significant effect on insulin bioavailability, and such problems as premenstrual syndrome, menopause, and infertility may be related to progesterone imbalance, and thus indirectly related to Metabolic Syndrome. Progesterone imbalance is defined by a relative imbalance of estrogens to progesterone, fluctuating in the menstrual cycle, but also related to the whole steroid hormone cascade, including androgen levels. Prostate hypertrophy, fibrocystic breasts, PCOS, and prostate and breast cancers may also be related to progesterone imbalance and indirectly linked to Metabolic Syndrome. Establishing a healthy hormonal balance may thus be an integral part to reversing Metabolic Syndrome, as well as preventing a host of serious diseases. A holistic assessment and step-by-step treatment protocol may be needed to restore a healthy metabolism, and professional guidance is absolutely necessary to achieve this goal for many patients.

An array of health problems is now associated with high insulin levels that result from insulin resistance in Metabolic Syndrome. Insulin and a related compound, IGF-1 (insulin-like growth factor), are integral parts of the mechanisms associated with malignancy in cancer cells. Insulin and IGF-1 act together in the cancer cells to drive the excess anabolic growth and spread of the cancer cells. Insulin is also found to alter the effects of pharmaceutical drugs on the cells by effecting cell membranes. Increased insulin facilitates the passage of drug molecules from the extracellular compartment to the intracellular compartment in many cells. This could increase the actions of various drugs, and create excess chemotoxic effects in cancer therapies for patients with Metabolic Syndrome. Presently, these effects are being investigated to see if chemotherapies can be enhanced with lower toxic chemical dosages and the use of insulin as an adjunct therapy in cancer chemotherapeutic regimens. Such research, though, demonstrates the problems that may occur in the patient with Metabolic Syndrome, and inexplicable increases in side effects from drugs. Breast and colon cancers cell membranes have been characterized as having plentiful insulin receptors, and chronic high insulin and insulin resistance may be a risk factor in these diseases. Insulin has also been researched in relation to brain function and immunological problems, and more and more serious health problems are showing potential links to chronic high insulin levels and insulin resistance. Insulin has long been recognized as an affector of cell membrane transport of glucose, but now research has revealed that insulin hormone also regulates transport of some amino acids, fatty acids, potassium, magnesium, and certain key monosaccharides. Health problems associated with these nutritional imbalances may be related to chronic high insulin states and Metabolic Syndrome.

While most of the insulin in our bodies is produced in the pancreas and broken down in the liver, with a lifespan for the insulin molecule mostly lasting only minutes in our bodies (the general half-life is about 10 minutes, and most insulin is catabolized in the liver within one hour), some insulin is also produced in the brain, and some is stored in fat cells. The insulin produced in the brain influences brain function, such as learning, memory and cognition, as well as vascular compliance (the elastic ability to respond to needed changes in blood pressure), DNA replication, modification of enzyme activities, and even the rate of degradation of damaged cell components called organelles (linking metabolic syndrome to neurodegeneration). The complex role of the insulin hormone in our bodies suggests that we need to pay attention to restoration of metabolic balance if we are to address all of our health problems and maintain the healthiest functional state possible. Integrating Complementary Medicine into your health regimen will help to maintain a better metabolic balance.

Diagnostics and treatment protocols in Diabetes and Metabolic syndromes

As stated, there is an obvious overlap of Metabolic Syndrome with diabetes, and a confusing lack of clarity between Type 2 Diabetes Mellitus, Prediabetes, and Metabolic Syndrome. In addition, there is sometimes a lack of clarity concerning Type 1 Diabetes Mellitus, both in determining the degree of degeneration of the pancreas function, and the extent to which other factors are contributing to the difficulties in controlling blood sugar levels. The intelligent patient will understand that a proactive approach to understanding and managing their individual case will pay big health dividends down the road. There is a tendency to treat all patients alike in the modern medical system, and with diabetes and metabolic disorders no two patients are exactly alike. No matter what your current diagnosis, understanding and attention to Metabolic Syndrome is very important to the management of your condition and prevention of future health risk, as well as improving quality of life.

Finally, in 2015, the U.S. National Heart, Lung, and Blood Institute clarified a treatment strategy for Metabolic Syndrome, indicating that non-pharmaceutical treatment protocols should always be used, with pharmaceutical prescription reserved for patients who do not respond to a holistic protocol. The goals of treatment in Metabolic Syndrome were defined as reduction in risk of coronary heart disease, including management of lipid balance, blood pressure and diabetes, and second, avoidance of a real progression to actual Diabetes Type 2. The treatment protocol recommended included improvement in the diet, with less meat and saturated fat, increased omega-3 essential fatty acids, fresh fruits and vegetables, legumes and whole grains, as well as avoidance of trans-fats. Healthy fats from plant sources were recommended, though, rather than a strict low-fat diet. Alcohol consumption should be limited to 2 drinks per day, and cigarette smoking curtailed. Physical activity on a daily basis needs to increase, with a minimum of 2.5 hours of aerobic exercise per week, which could include brisk walking and stair climbing. Stress management is emphasized, with exploration of various routines of stress management, meditation, relaxing therapy, and physical activity. Of course, Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) are not mentioned, but as this website shows, there is abundant proof of benefits with short courses of frequent acupuncture treatment, herbal and nutrient medicines, and even deep soft tissue physiotherapy, which can be integrated into the holistic protocol with just a little expense and effort.

If you are diagnosed as type I / IDDM, diagnosis is confirmed by a high random blood glucose of >200, or by 2 separate fasting blood glucose tests showing >140, and hyperglycemic symptoms, such as frequent urination, thirst, and hunger without satiation. In this case insulin is prescribed and self-administered in a combination of fast and slow acting forms, with attention paid to current blood glucose levels, measured by placing a drop of blood on a measuring device. This taking of insulin does not exempt the patient from the need to control the blood sugar with careful attention to balanced intake of food, and to controlled utilization of body sugars, fats, and proteins by timely exercise patterns associated with intake of food. Diagnosis of type II / NIDDM is often difficult, as the patient is experiencing only mild symptoms, and is confirmed also by 2 separate fasting glucose tests showing > 140, or by a hemoglobin A1c (HGbA1c) measure of >7.0%, or by an observed glucose tolerance test (OGTT). Recent findings have shown that chronic use of statin drugs may raise the A1C, that undiagnosed liver and kidney disease may raise the A1C, as well as various types of anemia, and numerous studies have pointed out the variance in testing even with the same blood sample at the same lab.

This initial diagnosis of Diabetes Type 2 is rarely clear, and the doctor may need to monitor blood levels, assess actual symptoms and signs, and adjust medications for a few months to control the disease. If the patient succeeds in improving their health and metabolic status during this period, they may be able to normalize the energy metabolism without drugs, or reduce the dosage or go off of these drugs in the near future. The NIH has stated that the use of A1c index alone is not sufficient to diagnose and monitor diabetes, and recommends that blood sugar levels, triglyceride levels, and C-reactive protein levels be monitored also and analyzed. If standard medications to increase insulin production and utilization are ineffective, this patient may need to inject insulin also in Diabetes Type 2, until the health is improved. An insulin inhaler is being developed successfully for this type of patient and may be on the market soon, but the problem with depending on an easy system of synthetic insulin delivery in Type 2 Diabetes is that the root of the problem is not a true deficiency of insulin, but rather a syndrome of insulin resistance at the fat cells, with inflammatory imbalance. No matter what treatment strategy is used, though, the ultimate goal should clearly be to improve the underlying health and not depend on medication if possible. Often, this type of diabetes is successfully controlled, and the patient taken off of medication eventually if weight is reduced, dietary/exercise patterns are successfully developed, and metabolic function is normalized. As stated, if weight loss is difficult, you must consider balance of the hormonal system and improved inflammatory regulation to gain success. Attention to the treatment of abnormal leptin and adiponectin levels, and resolution of insulin resistance and impaired glucose tolerance is often essential if sufficient weight loss is to be achieved. All of these immediate goals can be accomplished more efficiently by integrating Complementary Medicine in the form of a Licensed Acupuncturist and herbalist, or a Naturopathic Doctor.

Before describing dietary/exercise patterns, let me give you some final pieces of information you may want to know to fully assess the diabetic condition. This information, like much of the above information, may be too much to digest at this time, but will be of value to you later, to understand therapy and thus to achieve piece of mind and a sense that you are in control of your disease. Diabetes, more than any other disease is disease where the patient must assume full responsibility for the understanding and maintenance of the disease. Complete reliance on doctors and medications will lead to a poorly controlled disease, acceptance of symptoms that are worse than they need to be, and a sense of frustration and hopelessness as a person with an illness that seems to control and detract from your life. If you fully understand the disease and become comfortable with a diet/exercise pattern that works, you will be able to feel secure and lead a normal life. Understanding and improving metabolic fuction is a key part of the overall package of treatment protocol in diabetic states.

Three types or classes of diabetes mellitus (DM) have been recognized. The above descriptions constitute the first class. Also in this class are cases of diabetes secondary to (as a result of) other diseases, such as malnutrition, pancreatic cancer, hormonal disorders such as pheochromocytoma and Cushing's syndrome, and drug induced diabetes as commonly occurs with tuberculosis medications, estrogen therapies, dilantin, and corticosteroid use. A second class of DM occurs sometimes in pregnancy due to the high levels of estrogen or relative excess of estrogen due to progesterone deficiency. This type is diagnosed by an oral glucose challenge test and can be successfully controlled during the pregnancy, resolving after the birth. This type also occurs in other hormonal imbalances with deficient progesterone and relative excess of estrogen, which we see in PMS syndromes, irregular menstrual patterns, and menopausal states. The third class of DM is impaired glucose tolerance (IGT), with fasting blood glucose levels in the normal range of <140, but abnormal OGTT (oral glucose tolerance test), which means that the blood glucose is observed to be too high (140-200) up to 2 hours after eating, but is well controlled after that. Symptoms are mild in these patients, but risk of developing coronary heart disease and diabetes mellitus in the future is still great, and some attention must be paid to diet to insure a healthy aging process. Various herbs and nutrient medicines are now proven to help increase glucose utilization after eating, such as Crepe Myrtle, American Ginseng, cinnamon bark, and L-carnitine L-tartrate.

If you are diagnosed with type II NIDDM (non-insulin dependent diabetes mellitus) or IGT (impaired glucose tolerance), your diagnosis may not be clear and you may want to monitor your laboratory results and acquaint yourself with drug regimens. Pre-diabetic state is a very unclear diagnosis, and is often confused with Metabolic Syndrome. The Mayo Clinic states that Prediabetes is a state where blood sugar levels are higher than normal, but not consistently high enough to be clasified as Type 2 Diabetes Mellitus, and may progress in 10 years to a diabetic state. Given this timeline of progression, the patient seriously needs to consider more conservative means of restoring healthy metabolism and blood sugar regulation than going on harsh medications for the rest of their life. Taking a proactive approach and improving the health to reverse the prediabetic state, or Metabolic Syndrome, will result in avoidance of costly drug regimens with numerous chronic side effects, much improved quality of life, and avoidance of serious threats to health with aging. Patient education is the key, and understanding the laboratory tests is an important step in patient education. Normal values of pertinent blood chemistry levels are:

  • fasting glucose: 80-110 mg/dL (perhaps even higher in chronic cases) (updated in 2015)
  • glycohemoglobin: 5.5-8.5% (A1c index) (an average optimal level is considered below 7.0) (an average optimal level for children was revised in 2015 to below A1c of 7.5)
  • creatinine: .0-1.4 mg/dL
  • lipids (cholesterol bound): total serum: 450-850 mg/dL
  • cholesterol: 120-210 mg/dL, 20-30% HDL and 60-70% LDL
  • triglycerides: <160 mg/dL
  • total FA (fatty acids): 190-240 mg/dL
  • folate: 2-20 mg/mL
  • Vit B12: 200-900 mg/L
  • CRP: <1mg/dL or <10mg/L (c-reactive protein from the liver)
  • A1C: >6.5 may be used as an additional marker, but read below to understand how this marker can be misused in diagnosis; this is an advanced glycation endproduct (AGE), and more information on this subject is available elsewhere on this website

Another important marker for diabetic or metabolic disorder is the A1C index, or glycosylated hemoglobin A1C, a surrogate marker for blood glucose levels. A1C is the first important Advanced Glycation Endproduct (AGE) that is identified with metabolic disorder and indicates a problem with insulin metabolism at the cellular level (you may read my article on AGEs under the For Practitioners section on this website). The National Diabetic Association has stated that the A1C marker alone should not be used to diagnose and treat metabolic syndrome, or Diabetes type 2. The marker, which reflects chronic changes in red blood cell hemoglobin receptors in response to advanced glycosylation endproducts, which are molecules made up of sugars, fats and proteins that are abnormal to our physiology, was introduced as a diabetic marker in 1976, but not utilized in standard diagnosis until certain new diabetic medications reflecting insulin resistance therapy were introduced onto the market. A1C is proportional in most cases to the average glucose concentration over the previous 4-12 weeks, although many researchers find that it reflects average blood glucose in most patients for the last 2-4 weeks.

The American Diabetes Association in 2010 finally added A1C greater than 6.5% as an additional laboratory value useful in the diagnosis of diabetes, but again cautioned that A1C should not be the only diagnostic value that is used, and could indicate other metabolic problems not addressed by standard diabetes medication. The American Diabetes Association recommends that A1C be below 7.0% for most patients, and 7.5% for children and young adults, most of the time over a 2-4 month period, and that medicating patients with an A1C between 6.5% and 7.0% may engender more risk than benefit for many patients. An increasing concern with over-medication to bring the A1C index below 7.0 has occurred, with evidence of episodic hypoglycemic states, and adverse side effects of medication, creating more risk than benefit. The American Diabetic Association and the U.S. National Institutes of Health have now made clear that a number of factors may create a higher A1C index in a large number of individuals and groups, and numerous studies have now found that A1C measurements in the same lab from the same sample often vary. A 2014 study from the Weill Cornell Medical College in New York, New York, U.S.A. found that statin use was associated with a modest increase in Hb A1C, and since most patients with a perceived risk of diabetes are first prescribed statin drugs, the subsequent rise in A1C above 7.0 percent could be attributed to the statin use, not onset of diabetes. Further study in Finland found that chronic use of statin drugs increased risks of advancing to a diabetic state in 46 percent of patients, both by increasing insulin resistance and impairing the ability of the pancreas to secrete insulin effectively. Overuse of pain medications, such as aspirin and narcotic pain medication, may also increase the A1C marker by altering the blood assay, and a number of common conditions may increase the A1C index, such as iron and B12 deficiency, excess alcohol consumption, and liver dysfunction causing uremia or hyperbilirubinemia. Use of the A1C index alone as an indicator of diabetes, and lack of caution in over-prescription of DDP4 inhibitors to lower A1C is raising red flags in the medical community, especially as the long-term consequences of this drug therapy are still not apparent. The admitting of devastating mistakes in the prevention and treatment of Metabolic Syndrome and positive changes in treatment and prevention protocols is very slow coming forth.

While we now have much scientific information showing that standard protocol in prevention and treatment has been mistaken, the prescribing patterns for patients with Metabolic Syndrome have not changed, and in fact have gotten worse, with many patients prescribed problematic drugs with little diagnostic assessment, now depending completely on the A1C. Two patients with the same average blood sugar can have A1C levels that differ by as much as 3 percentage points, though. A1C in the range of levels generally found in very healthy patients is 4-5.9%, and the American Diabetes Association has determined that patients in a pre-diabetic state generally have an A1C level of 5.7-6.4%. Since A1C levels have a high variablility due to a variety of factors, though, a single high level, or an A1C level of 6.4% or lower, of even 7 %, may not be enough evidence to base a diabetes diagnosis, or even a pre-diabetic state, upon. Higher than expected A1C index can be seen in people with certain types of anemia, in which the red blood cell life span is longer due to abnormal shape of red blood cells, or decrease removal of old red blood cells by the spleen. This could occur with Vitamin B12 or folate deficiency, or other causes. A1C index should not be measured when there is a change of diet or phamacological treatment in the last 6 weeks. Also, patients with chronic abnormal blood loss, abnormal shape of red blood cells (e.g. sickle cell anemia), or other more rare disorders, may show a higher than normal A1C when there is no real diabetic disorder, and patients with chronic kidney or liver disease, which is often subclinical and undiagnosed, may also have a high A1C that is not attributable to a diabetic state. Careful diagnosis should be insisted upon, and the time should be spent to give each patient an accurate complete diagnosis before starting drug therapy. Patients may choose to utilize Complementary Medicine, in the form of acupuncture, herbal and nutrient medicine, along with dietary and lifestyle changes, during this period of repeated testing to confirm a diagnosis of diabetes, and see if drug dependency may be avoided. Diabetes is generally a slowly developing disease, and the risks in diabetic states are also generally long term and not immediate threats to the health, giving most patients time to improve the health to treat the disease and decrease future health risks.

Of all of the blood chemistry levels cited above, glucose and triglyceride levels are initially the most important to monitor as these show the extent of pancreatic and liver involvement, with high triglycerides pointing to a liver problem, and requiring a different medication strategy and lifestyle change. Glycohemoglobin count will point to a protein imbalance and the carrying of sugar as a principal problem. Creatinine count will point to kidney problems. Lipid counts will point to liver and cardiovascular dangers, and folate and B12 levels will point to a need to aid cell differentiation in the presence of enzyme deficiencies. CRP levels indicate chronic inflammatory states and liver dysfunction. Many doctors will not evaluate all of these levels, and thus it is important that the patient demand attention to all of these. In the holistic treatment of metabolic syndromes, identifying the focus of therapy with these various chemical markers is important to the Licensed Acupuncturist and herbalist who utilizes a modern evidence-based system along with traditional TCM diagnostic methods. It is important for the patient to obtain copies of these blood tests and bring them to therapy when using the Complementary Medicine physician to help resolve metabolic syndromes and control or reverse diabetic states.

In Type I IDDM your doctor may give you one type of medication, monitor your blood levels, and perhaps change medications and/or dosages if proper regulation of glucose and triglycerides are not maintained. In the early stages of Type I diabetes, the pancreatic beta cells may produce insulin, but the level of production may be insufficient or fluctuating. The NIH states that insulin producing pancreatic beta cells are generally not completely destroyed for 5-10 years in Type I diabetes. This means that careful monitoring of blood glucose is essential, and that patients in an early stage of the disease may take measures to delay the full destruction of the insulin producing cells in the pancreas. It is important to monitor your blood glucose levels before and after meals, and discuss intelligently with your doctor the need to adjust dosage or change medication. This is important both initially, as carbohydrate metabolism is being regulated, and later as you improve your diet/exercise patterns and are able to regulate the metabolism without aid of medications that have side effects. Insulin levels are best adjusted by use of an implanted pump, and improved methodology in monitoring blood sugar levels allows patients greater ease of insuring that optimum insulin levels are maintained. By increasing your health and conscious control of blood sugars and lipids, the body will need less insulin and the long term side effects will be decreased. Use of dietary regimens and herbs are not contraindicated or harmful, and large studies have shown that they play a beneficial, safe and complementary role in your treatment when monitored by a professional herbalist and knowledgeable Complementary Care physician. In addition, much research in the last decade has revealed that beta cells in the pancreas may regenerate in chonic diabetic states if the right protocol is utilized.

In Type I IDDM, the American Diabetes Association defines a normal range of blood sugars in adults before meals as 80-130 mg/dL, and before bedtime of less than 180 mg/dL. After the meals (postprandial), the blood sugar is expected to rise dramatically, and optimally, fall to fasting levels within two hours. The rate that blood sugars in circulation are processed is largely dependent on the insulin system, although a variety of factors contribute to this process. Patients need to monitor the blood sugar levels two hours after eating to determine if the body is processing sugar adequately. If the levels do not fall to a preprandial level fast enough, various therapeutic means may be utilized to improve the metabolic efficiency and help the body to achieve normal metabolic utilization of sugar, or carbohydrates. High postprandial blood sugars taken before the body has a chance to process circulating sugars do not indicate that the body needs a higher dosage of insulin. Initiating excess synthetic insulin dependence too early in the disease will reduce the body's own insulin responses, and may hasten the degeneration of the pancreatic insulin production.

Using sensible protocols and careful monitoring, patients may stimulate improved natural insulin production, and greatly aid the body's efficiency in processing carbohydrates and storing sugars as fats and proteins. For instance, avoiding excess carbohydrates in the meal, eating a careful balance of plant proteins, healthy fats and complex carbohydrates (whole grains and legumes), and avoiding excess meat and dairy consumption, will help the body to more efficiently utilize food nutrients and process them. A short brisk walk, or other simple aerobic exercise, following the meal will help the body to burn simple carbohydrates via exercise, taking stress off of the liver, and aiding efficient nutrient processing. Utilizing such herbs as medicinal cinnamon bark, crepe myrtle, Rhodiola rosacia, bitter melon, and American Ginseng, before the meal, or immediately after the meal, will aid the postprandial processing of carbohydrates as well. Improvements in the digestive health, liver health, and hormonal balance will also aid the body to process food nutrients more efficiently. The experienced Complementary Medicine physician, such as the Licensed Acupuncturist, will be able to design an individualized protocol of treatment to achieve these goals. All of these methods may be utilized to achieve a state of improved natural metabolic function and result in less dependency on synthetic insulin, and each individual may tailor the program to meet their needs regarding time and cost. The time spent to improve physiological understanding and gain a more intelligent proactive control of sugar metabolism will pay enormous dividends down the road in terms of future health and avoidance of health risks in diabetes.

Two types of medications are generally used to control Type II NIDDM. These are sulfonylurea agents, that stimulate insulin production and enhance insulin binding, and metformin/glucophage, a biguanide that acts on the liver to decrease sugar production and also enhances insulin binding. Recently, a new class of drugs is popularly prescribed, called glitazones, that seek to correct problems with insulin sensitivity, called Actos and Avandia. Unfortunately, these drugs have numerous side effects, including weight gain, water retention, anemia and hormone inhibition. Sulfonylureas have few side effects and act rapidly, and are thus the usual first choice. This group includes:

  • Tolbutamide/Orinase: short (6–12 hour) duration of action
  • Chlorpropamide/Diabinase: longest acting (60 hours) with a greater danger of hypoglycemic state
  • Tolazamide, Glyburide, and Glipizide: medium duration of action (12–24 hours) and fewer adverse reactions

Metformin/glucophage will have more severe gastrointestinal side effects, such as nausea, bloating, diarrhea and flatulence, and thus should be given first in a small dose, and as blood chemistry is checked, advanced to a larger dose if the patient tolerates. Metformin is beneficial in reducing cholesterol/fatty acids, and is considered essential if the triglyceride levels are too high. Studies do show that a large percentage of patients have insufficient blood sugar control after 5 years of usage of any of these drugs, though, pointing to the need for adopting an effective dietary, lifestyle and herbal regimen to increase your chances of long term success. Many patients are now opting to treat liver function, achieve hormonal balance, and lose weight, all with the help of Complementary Medicine, and then discuss with the prescribing M.D. monitoring the triglyceride levels as Metformin is withdrawn. Choosing to use improved metabolic health over excess drug dependency will pay many health dividends in the long run.

Recent Concerns over New Diabetic Drugs

In 2007, a well respected cardiologist at the Cleveland Clinic, Dr. Steven E Nissen, conducted a landmark study that suggested that the current best-selling diabetes drug, Avandia, raised the risk of heart attack considerably. This led to a congressional inquiry and subsequent safety warnings, with an appropriate drop in sales that was dramatic. Dr. Nissen was pressured to keep his findings out of publication in 2007, and anticipating the common maneuvering and misuse of scientific study, he secretly taped a meeting with the manufacturers of Avandia, GlaxoSmithKline, when they called him in for a meeting before his study was to be published in the New England Journal of Medicine. This story is presented in the New York Times, February 23, 2010, entitled 'A Face-Off on the Safety of a Drug for Diabetes'. In the meeting, GlaxoSmithKline referred to a yet unpublished, supposedly independent, study, that they purported had data that was contradictory to Dr. Nissen's study, and suggested that he hold off on publication, and accept an offer to perform collaborative research on this subject with their monetary help. GlaxoSmithKline was not supposed to have access to these independent studies until they were published in peer-review journals. Congressional investigations found that the company had been faxed copies of the unpublished studies by a worker at the medical journals who also was paid as a consultant for GlaxoSmithKline. Congressional investigation also revealed that GlaxoSmithKline's own scientists had concluded that Dr. Nissen's study was correct in evaluating an 11% increased risk for myocardial ischemia, or heart attack, with chronic use of Avandia, yet the company publicly claimed that Dr. Nissen's study was incorrect and poorly structured. The New York Times quotes the head of research at GlaxoSmithKline, Dr. Moncef Slaoui: “F.D.A., Nissen and G.S.K. all come to comparable conclusions regarding the increased risk for ischemic events, ranging from 30% to 43%."

The new class of Diabetic drugs addresses insulin resistance and inflammatory dysfunction in fat cells by binding to receptors called PPAR (peroxisome proliferator-activated receptors). By antagonizing these receptor functions, the drugs reduce insulin resistance and inflammatory mechanisms. Unfortunately, these PPAR receptors are now known to be expressed in many types of cells, especially in the heart muscle, liver, blood vessel endothelium, etc. Over time, decreasing the effect of PPAR may have negative consequences in the body, and this is why ischemic problems, as well as liver dysfunction and increase bone fractures have been noted. The ischemic problems affect more than the heart muscle, with increased risk of macular degeneration in the eyes, and increased muscle and joint pathology possible. Just as non-steroidal anti-inflammatory medications were eventually noted to cause inflammatory dysfunction and increase risks of cardiovascular pathology etc. over time, these types of drugs, like Avandia, have both potential beneficial and harmful effects that need to be more carefully considered by each patient and doctor.

Standard medicine still has little to offer with pharmaceutical drugs to treat Metabolic Syndrome, and hence has continued to imply that the enormous percentage of the population with this health problem actually has diabetes or a pre-diabetic condition that can be treated with the standard protocol for diabetes. This strategy has been disastrous, with enormous costs in healthcare, inattention to prevention of new cases of Metabolic Syndrome, and prescription of a multi-drug regimen that has created many adverse health effects. Patient understanding of Metabolic Syndrome and integration of Complementary Medicine and a holistic approach to reversing this multi-factorial disease is very important if we are to achieve success in reducing the incidence and consequences of Metabolic Syndrome.

Insulin resistance has been the subject of much research in recent years, and a number of therapeutic protocols have been shown to be effective in countering insulin resistance. Studies have confirmed significant benefits from specific acupuncture and electroacupuncture methods, herbal chemicals, and nutrient medicines. In addition, the complex subject of hormonal balance in insulin resistance has been intensely studied, and a variety of therapeutic protocols to improve levels of leptin, adiponectin and cortisol, as well as a better balance of progesterone and estrogens, have been developed to reverse insulin resistance. Each individual may have a different set of physiological problems that are contributing to insulin resistance, and an evidence-based modern Complementary Physician is able to develop an individualized treatment protocol to best address this complex and systemic health problem. You may go to a number of articles on this website to more fully explore insulin and insulin resistance, especially the article entitled Insulin Resistance in a Variety of Diseases. Since insulin resistance is a systemic and complex disorder involving the hormonal, immune and neurological systems, a holistic approach appears to the be a sound strategy for resolving this problem. An allopathic strategy of chemically blocking just a single pathway of this complex dysfunction does not seem to be a reasonable method of resolving or controlling insulin resistance.

Dietary Recommendations to Prevent and Treat Metabolic Syndrome

Dietary recommendations in Metabolic Syndrome and diabetes are very similar. In all types of diabetes, loss of fluids without replenishing is a major concern, though, and drinking of sufficient water or fluids, but not excess (5-6 cups per day unless sweating or urinating heavily), even in the absence of thirst, is very important. There are some dietary recommendations that are more pertinent to Metabolic Syndrome than diabetes, such as consuming foods that benefit improved inflammatory regulation, and achieving a balance of omega-3 and omega-6 fatty acids. Since liver steatosis (fatty liver) is a hallmark of the disease, avoiding a diet that contributes to this accumulating of cellular fat is very important, and avoidance of transfats, high-fructose corn syrup, advanced glycation endproducts (AGEs) in fast foods and snacks (fried sweet foods such as french fries, potato chips etc.), and excess stress of the liver metabolism (e.g. too many pharmaceutical and/or recreational drugs to process).

In 2016, experts at Newcastle University, and the Institute of Cellular Medicine, along with experts at the University of Glasgow, in the United Kingdom, completed the first of 3 human clinical trials of a dietary treatment for Metabolic Syndrome and Type 2 Diabetes, and showed that nearly half of patients with Metabolic Syndrome and obesity were apparently cured with a very low calorie controlled healthy diet for 8 weeks, followed by 6 months of healthy plant-based diet and avoidance of processed sugars, transfats and other food additives. This remarkable achievement occurred without drastic weight loss, with most obese patients achieving just a moderate 20-30 pound loss of weight, but restoration of metabolic health. To see a summary account of this dietary trial, just click here: . Of course, results could be improved with an holistic approach of daily exercise, hormonal balancing, and treatment with CIM/TCM to help improve liver, spleen/pancreas, kidney/adrenal, and immune function and health.

Standard solutions in the diet to the rise Metabolic Syndrome and diabetes type 2 have been shown to be not only confusing, but actually worsening of the public health problem. For instance, many years and many large scientific studies have now shown definitively that the substitution of 'diet' drinks and foods with artificial sweeteners of chemical origin have are actually now strongly linked to the rise of Metabolic Syndrome and Obesity itself. The food industry has heavily lobbied to delay this public health information, stating that 'no clear causative relationship' has been demonstrated, despite enormous population studies clearly showing a strong link between consumption of artificial sweeteners and Metabolic Syndrome. Finally, in 2010, researchers at the University of Texas Health Science Center, in San Antonio, Texas, U.S.A showed that in a 10-year randomized controlled study that individuals that drank diet soda regularly showed a growth in waist size by as much as threefold over those that avoided artificial sweeteners. The causative link appears to be the effects of these synthesized chemicals on the Human Biome. This SALSA study, published in the Journal of the American Geriatrics Society, clearly showed that regular consumption of 'diet' drinks in aging "was associated with escalating abdominal obesity, which may increase cardiometabolic risk in older adults", according the the lead auther Dr. Sharon Fowler. To see this study summary, click here: . Another large study, in 2016, one of a large series over the last decade that are still ignored, this time by Finnish researchers, clearly shows that the intake of dietary cholesterol, even for those with the APOE4 gene that increases poor metabolic regulation of cholesterol, does not significantly increase risk of cardiovascular disease, as we have been told for decades. To see a report on this study, click here: . The standard guidelines for prevention of Metabolic Syndrome have been shown to be alarmingly wrong in many ways, seemingly written by the food and pharmaceutcal industry to increase profits.

The primary consideration in diet in prevention and treatment of Metabolic syndrome is to help your body regulate sugars and lipids when normal regulation is challenged. Because of the inability to counter sugars or glucose from the diet, and regulate the storage and utilization of glucose, a number of basic considerations also need to be observed:

  • Meals need to be smaller and more frequent so that the body can handle the glucose loads more easily, and eating late at night should be avoided, as digestion is inhibited. Increased chewing is recommended.
  • During periods of inactivity less food should be consumed, especially carbohydrates, which convert easily to glucose; eat complex carbohydrates and avoid simple carbs.
  • In response to heavier meals, increased activity or exercise is essential to consume the increased glucose. A brisk walk may serve this purpose, or household chores. Use of a stationary bike or other exerciser is often quick and easy. The tendency to relax and be sedentary after the large meal is a natural response, but should be avoided
  • Likewise, before periods of increased activity or exercise, heavier intake of food, especially carbohydrates is essential. You will need the extra fuel.
  • A general balance between carbohydrates (50% of intake), fats (30%) and proteins (20%) should be maintained so as to supply glucose on a timely basis. Carbohydrates should be eaten in the form of complex carbohydrates, meaning whole grains and unprocessed natural sugars, such as honey and maple syrup, and simple carbohydrates should be avoided. The more bitter whole grains are reknowned for arterial cleansing, such as rye, quinoa, amaranth, and steel-cut oats.
  • Carbohydrates consumed should be whole grains and legumes, fresh vegetables, and some fruits in small portions (avoid large consumption of juices). Processed foods and cereals that are called whole grain are not complex carbohydrates.
  • Processed food and refined sugars should be strictly avoided, especially fatty food and pastries. If you must have sweet snacks, limit these to one bite.
  • Fats should be mostly polyunsaturated, such as safflower, sesame, corn, and walnut oils, but only unrefined and cold pressed versions, and these generally should not be used for frying. Monounsaturated oils, such as olive and sunflower should be used for frying. An emphasis on at least some consumption of omega-3 fatty acids from walnut oil et al, or supplements such as krill oil, is desirable to control cholesterol and aid the pancreas and immune system. Because of the poor regulation of lipids in the diabetic state, saturated fats such as butter, cheese, egg, and meat should be limited, but a very low-fat diet may be harmful. Margarine and refined oils and fats are trans-fats and are very bad in maintenance of cholesterol buildup and should also be avoided. The key to dietary fats is the consumption of healthy fats, mainly in the form of unprocessed, cold-pressed fresh oils, as well as a small amount of fresh nuts and seeds each day. Good supplements for omega 3 and 6 fatty acids include krill oil, spirulina, bluegreen algae and chlorella. One common mistake with patients is the simultaneous consumption of omega-3 fatty acids and the sudden elimination of red meat from the diet. When you eliminate red meat, your body needs to adjust to the decrease in omega-6 fatty acids such as arachidonic acid, and a sudden shift to an omega-3 relative excess is not healthy. Health arachidonic acids are available in vegetarian diets, though, be snacking on toasted nori seaweed and peanuts fresh from the shell. Consuming the spirulina and blue-green algaes will also help achieve balance.
  • These facts should be kept in mind about oils:
    • polyunsaturated oils reduce low-density lipoproteins (LDL) but also decrease healthy high-density lipoproteins (HDL).
    • monounsaturated oils do not deplete HDL and do not cause cholesterol to accumulate in the blood vessels.
    • Examples of healthy unsaturated oil sources in the diet include: almonds, pecans, hazelnuts, pine nuts, walnuts, sesame seed, flax seed, pumpkin seed, avocado, olives, soybeans, quinoa, garbanzo, miso, steel cut oats, brown rice, millet, corn and buckwheat. All of these whole foods and oils should be fresh and not rancid.
    • saturated fats (which also include peanut, coconut, and palm kernel oils) cause cholesterol to block arteries, although unprocessed coconut oil is partially saturated and easily utilized by our cells.
  • Protein choices should include more fish and fowl, beans and legumes, soy products, and small portions of nuts and seeds. A 2013 multicenter study by the Harvard School of Public Health, published in the Journal of Nutrition, found that 8 ounces of fresh walnuts per month was an effective preventive measure against Diabetes Type 2, or Metabolic syndrome, due the quality of omega-3 and omega-6 essential fatty acids, and other nutrients. A bag of fresh walnuts in the shell, purchased just once a month could provide significant benefits (see study link below in additional information). Beef and pork are more suited for wasting stages of the diabetic disease, and are not suitable for periods of weight gain, high cholesterol, hepatitis, nephritis, and hypertension. Meat portions should be small (2-3 oz) and the consumption of leafy greens, and sulfur vegetables such as broccoli, cabbage, onions and garlic will aid in their digestion. Meats also will often have chemicals and hormones that are toxic these days, and the consumption of ginger will help reduce these toxins. Animal products are generally high in both saturated fats and cholesterol. Cholesterol is the most abundant hormone in the body, and essential to health, and most cholesterol is produced by the body, although a diet with too high of a percentage of meat products will cause the body to decrease cholesterol production. Sudden changes in meat consumption may have an unhealthy effect on cholesterol production and balance in the body. Also, poor quality commercial meats may have poor quality cholesterols in them. In Metabolic Syndrome, it is important to make gradual changes in dietary habits, and work toward a greater percentage of healthy vegetables and whole grains over time.
  • Foods that are hypoglycemic, or sugar reducing, include garlic, onion, tomato, grape, carrot, fennel, peas, grapefruit, banana, cauliflower, black currant, eggplant and corn, and catechin-rich green tea has been found to have beneficial effects on postprandial glucose levels (avoid sugary green tea beverages, though)

Principal Concerns with Diabetes and Metabolic Syndrome

Metabolic Syndrome involves 3 major focal concerns: 1) Insulin resistance and chronic inflammatory stress at the fat cells, which are now considered an important visceral organ, producing much of our essential hormones and inflammatory mediators, as well as regulating energy storage in the body; 2) steatosis in the liver (fatty liver), or abnormal cellular accumulation of fats and inability to properly process triglycerides; and 3) obesity, or the abnormal growth of fatty tissues, which may be around the muscles of the midsection, or may be around the organs themselves, and not as visible.

The ideas that Metabolic Syndrome was primarily concerned with high cholesterol, and that obesity was a simple matter of individuals choosing to eat too much and not exercise are the past hallmarks of treatment concern that are now proven to be wrong and disastrous. Indeed, the recommendation of the U.S. Health and Human Services USDA Office of Disease Prevention and Health Promotion in 2015 was to forget about dietary cholesterol, finally admitting that this had little impact on the metabolic health, and in 2011 the recommendation was to consume a predominantly whole grain and plant-based diet, and avoid transfats and meat fats, as well as refined carbohydrates. These now well established hallmarks of Metabolic Syndrome demand a more holistic approach, and integration of Complementary Medicine and patient education, as well as public health strategies that change the modern diet and lifestyle. By allowing the food industry to do whatever it wanted to increase profits, we allowed an enormous amount of harm, and in fact the denying of essential rights, life, liberty and the pursuit of happiness. By not supporting healthy workplace activity and increased education in exercise and activity routines that insure metabolic health, we have created public harm. By not adopting holistic health and real preventive medicine, we have also encouraged the enormous rise in this threatening problem of Metabolic Syndrome.

A 2012 meta-review of all published studies on nutritional modulation of insulin resistance, by experts at The University of Warwick, in Coventry, United Kingdom, concluded that: "Weight loss with the reduction of abdominal fat mass almost invariably reverses insulin resistance as a consequence of chronic excessive energy intake in relation to physical activity levels. Therefore, any safe and balanced life-style measures that lead to weight loss and can be sustained in the long term have the potential to improve insulin resistance and glycemic control. However, particularly in patients with T2DM (type 2 Diabetes Mellitus, or Metabolic Syndrome), long-term sustained weight loss appears to be difficult to achieve. In this situation, isoenergetic changes of the macronutrient composition and the quality of ingested foods may exert important additional effects on insulin sensitivity. Nutritional measures that could be useful in this context include a Mediterranean-like dietary pattern (whole grains, fresh vegetables and healthy fats), but avoiding excess intake of dietary fat; substituting SFA (saturated fats) and TFA (transfats) by MUFA (monounsaturated fats) and n-6 PUFA (omega-6 essential fatty acids such as GLA and CLA); increasing cereal fiber intake (whole grains), particularly when choosing a high-protein dietary strategy (e.g. meat dominant). Weight loss, the macronutrient composition of the respective diet, aerobic exercise, and resistance training all appear to improve insulin resistance, by distinct mechanisms. Therefore, a combination of these interventions tailored to the requirements of each subject should be the cornerstone of management" (Scientifica Vol. 2012, Article ID424780). To achieve this goal, the one-size-fits-all dependence on pharmaceutical protocol needs to be recognized for what it is, a mistake. By adopting a holistic protocol, with advice and guidance from a Complementary and Integrative Medicine physician, such as a Licensed Acupuncturist and herbalist, this starting point for success can be achieved, and enhanced by short courses of acupuncture, herbal and nutrient medicine. CIM/TCM has long advocated this exact protocol, but has been largely ignored for decades. As the studies at Newcastle University in the UK from 2013-2016 showed, with an initial phase 1 of human clinical trials, a very low calorie diet of healthy foods for just 8 weeks, followed by a healthy plant-based whole food diet for 6 months is proven effective in reversing Metabolic Syndrome and Type 2 Diabetes without a dramatic weight loss, and combining such a therapeutic dietary routine within an individualized holistic protocol is sure to achieve even better outcomes.

To address these 3 main concerns, much scientific study is revealing the exact biochemical and neurohormonal pathways by which a treatment combining acupuncture, electroacupuncture, herbal and nutrient medicine could reverse these hallmarks of Metabolic Syndrome, and some of this amazing research is cited below in Additional Information with links to scientific studies. Such evidence not only assures both patients and physicians that Complementary and Integrative Medicine will work, but actually guides the CIM/TCM physicians in their treatment protocol. In the very near future these studies will advance to even more randomized controlled human clinical trials proving the exact pathways of benefit, and guiding formation of the best protocol, or combination of treatment modalities, for individual subsets of patients as well.

Treatment options and strategies in Complementary and Integrative Medicine (CIM) and TCM:

Treatment protocols for Metabolic Syndrome should be individually tailored to the patient, especially as this syndrome presents with such a variety of potential metabolic dysfunctions, and should always be combined with a healthy improvement in diet and daily exercise routines. The main therapeutic concerns may be triglyceride metabolism, liver function, and inflammatory regulation. Prevention or treatment of cardiovascular disease and neurodegenerative disease, which are highly associated with the progression of Metabolic Syndrome and Type 2 Diabetes, are also clear goals with CIM/TCM. Various Chinese herbal formulas are used routinely to promote liver function and vascular health, and are backed by both centuries of empirical evidence and much research and clinical knowledge in China, as well as a growing number of research studies in Europe and the United States. High triglycerides and blood sugars can be quickly controlled in most patients with these formulas, and the treatment goal is to utilize a comprehensive course with acupuncture, herbal formula, nutrient medicines, and advice on diet and lifestyle changes that will result in lasting benefit without dependence on chronic use of the herbal formulas. As seen in the section of this article entitled Additional Information and Links to Scientific Studies, there are a number of high quality studies at University Medical Schools across the world that now confirm that specific acupuncture stimulation and herbal chemicals are effective both at prevention of insulin resistance and reversing it. Short courses of acupuncture stimulation with more persistent and individualized herbal and nutrient protocols, could greatly enhance the progress made with sensible dietary and lifestyle changes. While Metabolic Syndrome cannot be reversed quickly, a simple adoption of these protocols insures that it will be reversed in time, and with this progress, weight loss may occur, accelerating the end to a Metabolic Syndrome.

While the herbal and nutrient research is extensive, and cannot be completely described on an article such as this, here are a few pieces of information that may help the patient understand how herbal and nutrient medicine may benefit them. A number of herbs are proven to help reduce your blood sugar more quickly after you eat, including Crepe Myrtle, American Ginseng and Cinnamon bark. Bitter melon extract and Coptis chinensis (with berberine) have also been proven as hypoglycemic, and aid treatment of Metabolic Syndrome by indirect means, such as enhancing insulin sensitivity, reducing oxidative stress, stimulation of glycolysis, and improving receptor function for lipoproteins. Better utilization and transformation of sugars or carbohydrates can be helped with a number of herbs which have long been used in Chinese hospitals. Efficient transformation of sugars in the liver may be helped with acupuncture and herbal formulas that stimulate healthier liver function to improve triglyceride and protein metabolism as well as cholesterol and lipid metabolism. Nutrient medicines, such as L-Carnitine and Alpha-Lipoic Acid, have also been found to be helpful in improving metabolic utilization. Since inflammation is a key problem in diabetes and insulin metabolism, anti-inflammatory herbs, anti-oxidants, amino acids, and essential fatty acid supplements etc. may make a big difference to treat the cause of diabetes and metabolic syndrome. Probiotics when needed to restore a healthy intestinal Biome have been shown to be an important part of the holistic treatment protocol. Since insulin is a steroid hormone and the endocrine system needs balance, use of bio-identical progesterone stimulating creams when appropriate have shown great improvement in diabetes clinically. The pioneer M.D., Dr. John R. Lee, has written extensively on this research. Acupuncture and herbal formulas, as well as supplements and creams, also are helpful to correct associated hormonal problems like adrenal stress and subclincial hypothyroid problems, which may be related. Although the herbal and nutrient medical approach is more complicated than taking a single pill, the end result may be worth the trouble. Many patients with a difficult disease try just one of these therapeutic tools at a time looking for the one that will provide a miracle cure, but this a misdirected approach, as the specialty of CIM/TCM and holistic medicine is designed to utilize a more thorough and interrelated set of protocols to gently restore the whole cycle of health problems creating dysfunction, and these various therapeutic tools often need to be combined in an intelligent and individualized treatment protocol.

Diabetes primarily causes inflammatory deterioration of the blood vessels and nerve sheaths, leading to peripheral neuropathy, circulatory problems, cardiovascular pathology, visual deterioration and kidney failure. Complementary and Integrative Medicine (CIM/TCM) offers the patient a variety of effective treatments for these disorders as well, treating both the manifestation of the disease as well as the disorder itself, and able to individualize the treatment for each patient.

Since the array of problems in diabetes can be so broad, you need to discuss the particular therapies and options with a knowledgeable practitioner. Each individual may need a unique step-by-step treatment protocol, and both immediate goals and long-range goals need to be discussed. With Complementary and Integrative Medicine (CM/TCM) the therapies should be goal oriented, and continuous and chronic use of medications is not the proper protocol, as in standard medicine. Resolution of the various factors that cause Metabolic Syndrome and restoration of normal homeostasis is the goal, and short courses of acupuncture stimulation with more than one treatment per week will provide a synergistic therapy that enhances the effects of the holistic protocol with herbal and nutrient medicine, diet and lifestyle changes. As always, the health benefits from this treatment strategy will help you to both treat your diabetes and become a healthier and more productive person.

Nutrient Medicines helpful in the treatment of Metabolic Syndrome

While there are many nutrient supplements on the market, particular nutrient medicines may have a marked effect on the metabolic health, often by stimulating deficient metabolic processes with a short course of therapy. While all of these vitamins, amino acids, enzymes, and essential fatty acids may help the metabolism, we can't take them all, and increased knowledge of what to take is very important. In addition, studies of the general population find that true deficiencies of most nutrient chemicals are rare, but that deficiencies of certain nutrients are very common. The common deficiencies noted in population studies are Vitamins B12, B6, B1 thiamin, folic acid, and Vitamin C. These nutrient classifications, though, encompass a variety of chemicals with the same general classification, and quality and type of these nutrients in commercial supplements have proven to be extremely varied. Utilizing the best professional companies, and professional advice from a Complementary Med physician insures that you receive the best and most effective product and course of therapy.

There are some professional formulations that combine a number of the key supplements listed below, although to obtain effective dosage and quality, purchasing individual supplements is the sure bet. One nutrient formula that is recommended is Optimum D from Vitamin Research, which contains Pantothenic acid, B3 Niacin/niacinamide, Biotin, and Chromium picolinate, along with B6, B1, B2, E, C, active folic acid (5MTHF), and various minerals. Of course, simple protocols with specific nutrient supplements have limited benefit, and are meant to be part of a more holistic and thorough protocol. Taking just one or two or these supplements will not cure Metabolic Syndrome by itself, and professional guidance and a step-by-step treatment protocol that is individualized is important.

  • Vitamin B5 Pantothenic acid: an essential nutrient, pantothenic acid is critical in metabolism and synthesis of proteins, carbohydrates, and lipids, as well as enzyme activation and deactivation via signal transduction acylation and acetylation; pantothenic acid is essential to the formation of Coenzyme-A, which is essential to formation of healthy fatty acids, cholesterols, acetylcholine neurotransmitter, and ACP. Marked nutritional deficiency of B5 may create insulin sensitivity hypoglycemia, adrenal insufficiency, fatigue, asthenia, restless insomnia, immune disorder, burning sensations and other paresthesias to the feet and hands, muscle cramps, and abdominal cramping. Food sources include endive, escarole, peas, cucumber, watercress, tomato, fava bean, mung bean sprout, steel cut oats, strawberry and avocado, as well as bee pollen. B5 supplement as calcium pantothenate is recommended periodically, but not with continuous use.
  • Vitamin B3, Niacin, Niacinamide, and Inositol hexacotinate: the National Institutes of Health have confirmed that niacin is very effective in lipoprotein and cholesterol imbalances, and benefits increase in HDL better than statin drugs, as well as being effective for reducing atherosclerotic plaque accumulations. Niacin and niacinamide are also helpful with gastric hypofunction, a problem frequently misdiagnosed as hyperacidic condition with acid reflux. There are some potential problems with niacin, the chief of which is the sensation of strong heat flush with use in most patients during the first few weeks. This flushing sensation with niacin has been found to be beneficial rather than harmful, though, in studies, and Niacinamide and non-flushing variations of niacin do not produce this flush. B3 Inositol hexacotinate is a niacin variation that is useful in the central nervous system. Excess niacin may worsen glycemic control, and this should be monitored with diabetes, and dosage should be less than 500 mg daily. Seaweeds, such as toasted nori seaweed, hijiki, and wakame, are good sources, as is asparagus, bean sprouts, tomatillo, peanut, and bell pepper. Unprocessed whole grains are also a good source of niacin, lecithin and the best forms of Vitamin E (tocopherols). The use of synthesized niacins, or nicotinic acid drugs, has been found to be problematic.
  • L-Carnitine L-Tartrate: L-Carnitine if a B Vitamin with a structure similar to an amino acid that helps transport long-chain fatty acids, and thus helps utilize fats, prescribed now routinely for high triglycerides, fatty liver, weight loss, and heart disorders. A number of other nutrients can be taken as precursors to increase liver production of carnitine, and this formula consists of Vitamins B6, B1, and C, L-Lysine, zinc monomethionine, and iron rich foods. Vegetarians are more likely to experience deficiency of L-Carnitine and L-Lysine. L-Carnitine and Niacinamide are prescribed to help induce remission of autoimmune Type 1 Diabetes Mellitus.
  • Biotin: This supplement showed dramatic promise in animal studies in resolving impaired glucose tolerance and excess secretion of insulin in Metabolic Syndrome (see study cited below). Biotin is also called Vitamin H or B7, and is important in gluconeogenesis, or conversion of fats and proteins to glucose. It is also vital to synthesis of fatty acids, and is used in the citric acid cycle to create cellular energy. While biotin is more well known for aiding the hair and nails, it is important to metabolic processes and maintaining a steady blood sugar. Deficiency of the enzyme biotinidase is even more common, creating difficulty in utilizing biotin from food or supplement. This enzyme is produced by healthy bacteria in the gut, and is another reason why intestinal dysfunction and bowel irritation are often seen in Metabolic Syndrome. Deficiency of biotin may cause high blood sugar, anemia, hair loss, depression, skin inflammation, and sore tongue and membranes. Biotin is found in brewer's yeast, egg yolk, soybeans, whole grains, saltwater fish and poultry, as well as milk and meat. Biotin has been found to be essential to activation of various carboxylase enzymes that catabolize cholesterol, essential amino acids, and fatty acids, and so supplementation may have quite an effect. Some patients have read that it is healthy to eat egg whites without the yolks, and this dietary habit has resulted in documented biotin deficiency. Biotin deficiency is also seen in pregnancy, liver cirrhosis, and as a side effect of anticonvulsant medications.
  • L-Tyrosine: this amino acid is important to overall metabolism, helps reduce excess body fat, and aids in adrenal, hypothalamic, and thyroid function. An added benefit is that it is a precursor for the neurotransmitters dopamine and norepinephrine (adrenalin), which regulate mood and libido. Tyrosine is essential to creation of thyroid hormones by being the active link of iodine to the hormone. Food sources include pumpkin seeds, almonds, lima beans, avocados, sesame seeds, dairy and bananas.
  • L-Isoleucine with L-Leucine and Valine: this amino acid helps stabilize and regulate blood sugar levels, and has been found to be deficient in people suffering from a wide variety of mental and physical disorders. A deficiency of isoleucine causes symptoms similar to those of hypoglycemia. Food sources include almonds, garbanzos, lentils, eggs, fish, rye, soy and most seeds. L-Isoleucine should always be taken with the two related branched-chain amino acids listed above, and these are often included in amino acid supplements for athletes, as they help repair muscle tissue. The protein powder Amino Edge from Vitamin Research contains these amino acids with a complete amino acid profile, iron, potassium and selenium. A little more expensive is the Smart Protein powder, with low temperature processing of naturally occurring bioactive proteins and undenature whey protein, combined with calcium, magnesium and potassium.
  • Gamma Linoleic Acid plus Omega-3 Fatty Acids: GLA promotes PGE1 (prostaglandin E1), and Omega-3 sufficiency promotes PGE3, which act together to regulate the action of insulin. Avoid excess alcohol consumption, as this depletes PGE1. Sources include: Krill oil for Omega 3 fatty acids, fresh shelled walnuts, unprocessed walnut oil, spirulina, blue-green algae, black currants, borage seeds, evening primrose oil, and flax oil. I prefer the GLA from Vitamin Research, which is derived from black currant seed oil, and contains a desirable fatty acid profile with essential linoleic and linolenic acids, as well as the Omega-3 stearidonic acid. A number of Chinese herbs also contain these essential fatty acids in concentration.
  • Chromium picolinate: chromium deficiency is still poorly understood, but is linked to poor potency of insulin regulating function. Trivalent chromium is essential for proper metabolism of sugars. Chromium is found in many green and red foods, brewer's yeast, dried beans, whole grains, blackstrap molasses, calf liver, wild mushrooms, and brown rice. It is also available in the herbs red clover, wild yam, nettle, sarsaparilla, and horsetail. Lack of chromium in our soils due to commercial farming has created widespread chromium deficiency in the United States.
  • Polilipid - Sytrinol from cirtus and palm fruit extracts: This patented formula from Health Concerns has completed clinical studies that confirm cholesterol reduction, LDL reduction, and reduction of triglycerides by 34% within 4-12 weeks, with positive effects on apoprotein B and A1 levels.
  • Bitter melon extract / Momordica charantia: numerous studies have demonstrated significant benefit of bitter melon extract in Metabolic Syndrome, with lowering of blood sugars, and regulation of insulin release demonstrated in cell culture, animal and human studies. This extract also has potent antioxidant and anti-inflammatory effects, and is effective to reduce herpes expression. (see the citation below)
  • Turkeytail mushrooms / Coriolus versicolor: these will help regulate the blood sugars as well as act as a potent immune stimulant.


The most reliable resources, and the main resources for this paper are:

  • Healing with Whole Foods by Paul Pritchford
  • Prescriptions for Nutritional Healing by Phyllis and James Balch

Information Resources

Inclusive facts on diabetes are from: Pathophysiology, Clinical Concepts and Disease Processes by Price and Wilson, Cecil's Essentials of Medicine and the Merck Manual

Additional Information and Links to Scientific Studies:

Much evidence is accumulating to help guide the modern herbalist and Licensed Acupuncturist in the best course of therapy for the patient with Diabetes and Metabolic Syndromes. Herbal formulas and specifics, as well as novel nutrient medicines, are being heavily researched, and Complementary Medicine is being heavily utilized in many countries in this type of therapy.

  1. A German professor and medical researcher referred to Metabolic Syndrome in 1977 as a well-known combination of high lipoproteins, high blood sugar, fatty liver, obesity and excess uric acid, with abnormal clotting factors and blood viscosity increasing the incidence of atherosclerosis:
  2. By 2009, a concern for Cardiometabolic Syndrome developed, and these experts at the Center for Human Nutrition at the Washington University School of Medicine, in St. Louis, Missouri, defined this pathology as still poorly understood, but involving multi-organ insulin resistance, leading to high blood pressure by affecting the kidney function, alterations in the the organ of fatty tissue and adipokine metabolism, and excessive free fatty acid release, noninfectious systemic inflammation increasing cytokine production in fat cells and contributing to insulin resistance, and increased free fatty acids to the liver leading to excessive VLDL triglyceride production, or steatosis:
  3. In 2011, a study of 161 obese children, in Budapest, found that insulin resistance developed in obese children even independent of cardiometabolic risk, but with increased cardiometabolic risk, seen in about 27 percent, substantial insulin resistance even before puberty was measured. These findings indicate a severe public health problem as an alarming percentage of children in developed countries show signs of obesity, with costs of future health care for individuals with Metabolic Syndrome astronomically high:
  4. A large retrospective cohort study by the University of Texas, the University of Minnesota, and Johns Hopkins University in the United States, and the University of Oslo, Norway, found that a strong association between intake of diet soda with artificial sweeteners and risk of Metabolic Syndrome, Diabetes Type 2 and cardiometabolic health problems is evident. Many of the standard protocols to prevent obesity and Diabetes Type 2, including chronic use of statin drugs to lower cholesterol, are now linked to onset of Diabetes Type 2, showing that a new medical paradigm is urgently needed:
  5. In 2015, experts at the University of California in La Jolla, California, U.S.A. found that childhood obesity and insulin resistance in Metabolic Syndrome directly affects kidney function, and that markers such as elevated urinary NAG and KIM-1 provided biomarkers of the disease that may be predictive of future kidney disease in obesity and diabetes. NAG, or N-acetly-beta-D-glusoaminidase, is a protein enzyme the regulates bonding of sugars and proteins (glycosides and amino acids), and health of cell membranes:
  6. A 2016 study at the Maastricht University School of Medicine, in The Netherlands, showed in a large cohort study of 120,852 men and women age 55-69, that at the beginning of the study, 3.1 percent had been diagnosed with Type 2 Diabetes, with 80 percent diagnosed after age 50, and that the risk of developing proximal colorectal cancer was significantly increased in this subset, especially for women over the age of 60. Other studies have noted modest overall increased risk of cancer in Type 2 Diabetes that is related to aging:
  7. In 2015, research in China found in a large population study that serum Gamma-Glutamyltransferase (GGT) and serum ferritin (iron storage molecule) are clearly associated with insulin resistance. Such biomarkers are useful to define and diagnose types of Metabolic Syndrome, but are also an indication that such problems as altered iron metabolism and iron overload toxicity are integral to the disease, and require a more holistic treatment and prevention approach:
  8. A 2012 meta-review of all published studies concerning nutritional modulation of insulin resistance by experts at The University of Warwick, Coventry, UK, found that a combination of basic dietary and lifestyle habits should be the foundation for a more individualized and holistic protocol to reverse insulin resistance. These experts noted that weight loss is often difficult for individuals with Metabolic Syndrome and type 2 DM, and without a more holistic and persistent protocol, achieving weight loss in syndromes of insulin resistance is very difficult. The basic nutritional strategy of a Mediterranean-style diet with healthy fats and whole foods in a plant-based diet, avoidance of excess saturated fats and transfats (meat and processed foods), increased cereal fibers (whole grains), increased daily aerobic exercise and regular resistance training, and then an expected weight loss, is needed to actually reverse insulin resistance and Metabolic Syndrome leading to type 2 diabetes:
  9. A 2013 study by Dr. Rod Taylor, Professor at the Newcastle University Institute of Cellular Medicine, in Newcastle upon Tyne, United Kingdom, showed that Metabolic Syndrome, or Type 2 Diabetes, can be quickly reversed and cured with a low-caloric diet that sticks to avoidance of starchy and processed foods, and meats, for just a short period of time. The initial first human clinical trial showed a 50 percent complete cure rate using this approach in 2016, and will be followed by larger human clinical trials:
  10. A 2016 summary of research by Newcastle University provides abundant proof that a more holistic protocol can reverse and cure Metabolic Syndrome and Type 2 Diabetes:
  11. A2016 study of the association of sleep duration with Metabolic Syndrome, by experts at the Vrjie University School of Medicine, in Amsterdam, and Newcastle University in the U.K. showed that there was a strong correlation in men but not women, with both less than the norm of 7 hours per night and more than 7 hours of sleep in men strongly associated with decreased insulin sensitivity, insulin resistance and pancreatic beta cell function. This study implies that quality of sleep and differences in circadian rhythm regulation between men and women could be the main factor explaining this disparity. They acknowledge that use of sleep medication was not factored into potential cause, despite the fact that many pyschotropic drugs are linked to Metabolic Syndrome and obesity, and that the most popular prescribed sleep medication, Zolpidem, or Ambien, is metabolized much more efficiently in men than women, a potential explanation:
  12. A 2007 study showed how excess free fatty acid metabolism is a key to Metabolic Syndrome and Type 2 Diabetes, with both destruction of pancreatic beta cells and hyper-stimulation of remaining healthy beta cells, leading to insulin resistance:
  13. A 2015 study at the Federal University of Vicosa, in Brazil, and the Rovira i Virgili University, in Spain, found that even among health professionals in Vicosa, Brazil, that incidence of Metabolic Syndrome was 4.5 percent, and increased with age. The presence of Metabolic Syndrome was also highly correlated with cardiovascular risk. Such study shows that we need more than the standard treatment protocol to reverse this disease syndrome:
  14. A 2014 study at Johns Hopkins University Medical School discovered that a third key hormone is very important to the onset of Type 2 Diabetes, with the liver hormone kisspeptin 1 (K1) perhaps as important to the pathology as insulin and glucagon, as this hormone K1 was found to directly suppress pancreatic beta cell function. An imbalance of insulin and glucagon, sort of the yin and yang of metabolic sugar control, was found to result in a relative excess of glucagon in the liver, which triggers excess release of K1 into the bloodstream, where it is carried to pancreatic beta cells and suppresses insulin secretion. This finding may be the missing link between the advancement of Metabolic Syndrome to Diabetes Type 2, and more research is sure to reveal a greater complexity in this liver metabolism:
  15. A large randomized controlled human clinical trial of the Chinese herbal chemical resveratrol for the prevention and treatment of fatty liver disease, associated with insulin resistance and Metabolic Syndrome, was proposed in 2015 by the University of Manitoba and The Manitoba Institute of Child Health, showing that the research revealing that this herbal chemical, developed by the Chinese from the herb Polygonum cuspidatum, or Hu zhang, is an important part of a holistic protocol to treat and prevent Metabolic Syndrome:
  16. A 2008 review of research data concerning Traditional Chinese Medicine and herbal formulas and specifics in the treatment of Metabolic Syndrome at the Pennington Biomedical Research Center of Louisiana State University:
  17. An explanation of the Chinese nutrient supplement Red Yeast Rice, from which statin drugs were developed, and the addition of Berberine, an active chemical in Coptis chinensis, or Huang lian, as well as other common Chinese herbs, shows that a number of randomized controlled human clinical trials have been conducted with this therapy for Metabolic health in China in the last decade, and that these studies show that the synergistic combination provides an array of benefits with none of the adverse health effects seen with chronic use of statin drugs:
  18. A 2015 study at the American University of Beirut, in Lebanon, showed that an unhealthy intestinal Biome (dysbiosis) is a link between the related pathologies of Type 2 Diabetes, Inflammatory Bowel Disease, and Colorectal Cancer, linking regulation of inflammation and increased physiological stress to these diseases, suggesting that clearing of excess pathogenic organism and restoration with Probiotics should be integral to the holistic treatment protocol:
  19. A 2009 study at the Chongqing Medical University in Chongqing, China, showed that electroacupuncture at the common points ST36, SP6, and LV3, significantly improved chemical parameters of nonalchoholic fatty liver disease, a hallmark of metabolic syndrome, raising SOD content in the liver (a key antioxidant), and decreasing malondialdehyde (MDA) levels (toxin accumulation) and P450 cytochrome levels, showing improved liver function, effectively reducing lipid peroxidation:
  20. A 2015 study at Santa Christina University, in Madrid, Spain, showed that non-alcoholic steatohepatitis (NASH) was present in 10.2 percent of 218 consecutive patients diagnosed with gallstones, and that simple steatosis (increased fat in the liver cells associated with poor liver function and inability to properly process triglycerides) was observed in 41.4 percent of these patients. The research showed that while fatty liver disease was less associated with gallstones than previously thought, that it was highly associated with Metabolic syndrome:
  21. A 2007 study at the Beijing University of Chinese Medicine, in China, found that electroacupuncture at common points, SP6, ST40, and manual acupuncture at DU20 and DU26, lowered total cholesterol, LDL-C (low-density lipoprotein cholesterol) and triglycerides, and suppressed neural growth factors (NGF) associated with ischemic brain injury, in study animals:
  22. A 2014 multicenter study at the University of Texas Medical Branch in Galveston, Texas, U.S.A. and Guangdong Academy of Medical Sciences, in China, found that electroacupuncture stimulation at 3 Hz and 15 Hz significantly improved glucose tolerance and insulin sensitivity in study animals with induced Metabolic Syndrome, probably attributed to reductions in free fatty acids:
  23. A 2012 study at the University of Otago, New Zealand, found that electroacupuncture with 2 Hz and 15 Hz at the points ST36 and Ren 12 for 30 minutes significantly lowered blood glucose in study animals, and future studies would be designed to show that such treatment improved insulin metabolism, lipid profiles, free fatty acid levels, circulation and nerve conduction:
  24. A 2013 randomized controlled study of electroacupuncture as part of the holistic treatment of Metabolic Syndrome, by experts at the Wuhan University School of Medicine, in Wuhan, China, found that both manual acupuncture stimulation and electroacupuncture at the points ST36 and Ren12, performed daily for 4 weeks, significantly decreased triglycerides, total cholesterol, LDL-C and HS-CRP (C reactive protein, a key marker of cardiovascular disease), and the adiponectin and HDL-C were increased with manual stimulation of the acupuncture needles. These effects were not seen in the control or model groups of laboratory animals:
  25. A 2013 randomized controlled study of electroacupuncture as part of the holistic protocol to treat Metabolic Syndrome at the Anhui College of Chinese Medicine, in Hefei, China, found that electroacupuncture stmulation of the points PC6 and UB15, performed every other day for 12 weeks significantly improved levels of triglycerides, total cholesterol and HDL-C, and also increased expression of CD 40 and MMP-9 proteins, indicating benefits in prevention of cardiovascular disease. The electroacupuncture stimulation outperformed controls treated with standard pharmaceutical drugs. Such studies show that these acupuncture treatments, performed in short courses of frequent treatment, as part of a more comprehensive treatment protocol in TCM clinical practice, provide proven significant benefits as part of a more holistic integrative treatment protocol:
  26. A 2006 review of the scientific evidence concerning bitter melon extract and lowering of blood sugars at the Justus-Liebig University Institute of Nutritional Science in Giessen, Germany:
  27. A 2008 study at the Pennington Biomedical Research Center of Louisiana State University, found that a number of Chinese herbs are useful in the management of Metabolic Syndrome, including the most well-studied American Ginseng, Coptis chinensis, and bitter melon extact:
  28. A 2011 study at China Academy of Chinese Medical Sciences in Beijing, China, Guanganmen Hospital, elucidated that ways that Coptis chinensis (Huang lian) improves sugar metabolism and aids reversal of insulin resistance in Diabetes type 2 or Metabolic Syndrome. Tests revealed that herbal formula with Coptis improved glucose tolerance, lipid metabolism, reduced serum leptin levels without affecting adiponectin, and improved muscle cell utilization of glucose.:
  29. A 2014 study at Grangdong Pharmaceutical University, in Guangzhou, China, found with extensive testing of both metabolic parameters and actual genetic expression in liver and fat cells, that a typical Chinese Herbal Formula used to treat Metabolic Syndrome, or Type 2 Diabetes, called FTZ, actually reversed insulin resistance in liver and fat cells, as well as lowering circulating triglycerides, total cholesterol and fasting blood sugars. The formula consists of Ligustrum lucidum / Nu zhen zi, Salvia miltiorhiza / Dan shen, Coptis chinensis / Huang lian, Panax notoginseng / San qi, Eucommia ulmoides / Du zhong, Cirsium japonicum / Da ji, and Citrus medica / Zhi shi: / or go to:
  30. A 2014 study at the Shanghai University of Traditional Chinese Medicine, in China, showed that the Chinese herb Coptidis (Coptis chinensis), or Huang lian, both prevented and resolved insulin resistance in fat cells induced by the pro-inflammatory cytokine TNF-alpha:
  31. A 2013 study at Shanghai Jiaoteng University, in China, showed that the chemical paeoniflorin, found in the Paeonia species P. lactifolia, or Bai shao, and P. suffruticosa, or Mu dan pi, is able to prevent insulin resistance in fat cells induced by TNF-alpha inflammatory mechanisms. Prior studies showed that paeoniflorin also attenuated lipolysis, or the breakdown of stored fat, in human fat cells:
  32. A 2010 study at the University of North Carolina-Greensboro, in the United States, showed that the Chinese herbal chemical quercetin was as effective or more effective than the related Chinese herbal chemical resveratrol in reversing insulin resistance induced by inflammatory TNF-alpha. Both of these herbal chemicals are now standardized. Herbal supplement pills with a combination of these two chemicals may be most effective:
  33. A 2008 study at The University of Hong Kong, York University and other institutions, found that the herb Astragalus, or Huang qi, increased adiponectin production and decreased insulin resistance in the treatment of Metabolic Syndrome, in preliminary studies with animals:
  34. A 2011 study at Hoshi University, Tokyo, Japan, confirmed extensive studies at the University of Minnesota (Leptin X) and the University of Connecticut, on the effects of Acacia polyphenols, and other chemicals to counter Metabolic Syndrome. In this animal study of obesity, adiponectin levels were increased, excess insulin suppressed, TNF-alpha in white adipose tissue suppressed, and fatty accumulation in the liver decreased. The University of Minnesota studies in human clinical trials showed significant modulation of leptin metabolism, leptin resistance at the hypothalamus, and normalization of the insulin cascade, involving insulin, leptin and adiponectin:
  35. A 2009 study of green ECGC (epigallocatechin-3-gallate), commonly called catechins, at Ewha Womans University, in Seoul, South Korea, found that green tea catechins effectively reduce adipose, or fatty, tissues and improves lipid metabolism in studies of obese laboratory animals:
  36. A randomized controlled 2016 study at the Fujian University of Traditional Chinese Medicine, in Fujian, China, showed that the Chinese herb Artemisia capillaris, or Yin chen hao, widely used to treat liver disease, inhibits fatty liver via miR-122 RNA pathways that regulate the fatty acid metabolism. Here, a dosage-related treatment lowered triglycerides and LDL-cholesterol, normalized liver enzymes, and decreased expression of fatty acid synthase. This miR-122 pathway is also implicated in excess reproduction of the hepatitis C viruses:
  37. Cardioprotective effects of European Olive leaf tincture were identified in 2003, preventing high blood pressure and atherosclerosis, while also improving insulin metabolism and providing antioxidant clearing of arteries:
  38. Cardioprotective effects of the unique Chinese herb, Rhodiola rosea, or Hong Jin Tian, were reviewed in 2007:
  39. A 2015 study at the Nigata University of Pharmacy and Applied Life Sciences, in Nigata, Japan, found that the Chinese herb Siberian ginseng, or Acanthopanax senticosus, is effective in reducing high triglycerides and resolving Metabolic Syndrome in laboratory animals with induced lipid imbalance:
  40. Cardioprotective effects of Omega-3 fatty acids, EPA and DHA, were reviewed in Europe in 1999, and have become standard therapy following a stroke or myocardial infarction (heart attack). Krill oil presents the high quality and most concentrated type of this supplement, with a natural preservative, unlike fish oils:
  41. Studies in 2012, published in the Journal of the American Medical Association (JAMA), followed over 160,000 post-menopausal women from 1993 to 2005 and showed that use of all types of statin drugs to lower cholesterol in post-menopausal women resulted in increased risk for developing true Diabetes. With numerous studies demonstrating that lowered lipid cholesterol, balanced lipid metabolism, and significant reduction of cardiovascular risk can be achieved with diet, lifestyle changes, herbal and nutrient medicine, and acupuncture, integrating these treatments of Complementary Medicine and monitoring results is becoming increasingly utilized by patients:
  42. Studies in 2013, published in the medical journal BMJ, or British Medical Journal, reviewed all medical records of patients in Ontario, Canada, age 66 or over, from 1997 to 2010, who were not diagnosed with diabetes, but started on a statin drug regimen, and found that treatment with higher dosage statins was associated with increased risk of new onset diabetes, and evidence presented by the Cornell Weill University suggested that statin drug use could raise the A1C index:
  43. A 2012 study by experts at the Madras Diabetes Research Foundation, in coordination with the World Health Organization (WHO) found that while the hemoglobin A1C index marker was useful and accurate for most patients when monitored over a period of up to 4 months, there are a number of factors that could alter this blood assay, including various medications, nutritional deficiencies, and conditions related to liver and kidney health:
  44. A U.S. AHRQ (Agency for Health Research Quality) report on the variety of diabetic medications that are purported to lower the A1C index reveals that a number of types of medications may lower this marker of metabolic dysfunction, and that each of these medications has potential common adverse side effects that should be considered:
  45. Studies in 2010 presented by the American College of Cardiology showed that the array of medications commonly prescribed to reduce risk for patients with metabolic syndrome are not only ineffective, but actually increased cardiovascular risk for most patients:
  46. Studies in 2010 of the general population found a significant variance in incidence of high blood sugar and HDL lipoprotein, as well as high blood pressure, between summer and winter, indicating that diagnosis and management is more complex than we thought:
  47. Studies in 1996 in Japan found that supplementing with biotin corrected impaired glucose tolerance and decreased excess insulin in laboratory animals with Type 2 Diabetes or Metabolic Syndrome:
  48. Studies in 2010 by the West China School of Pharmacy in Chengdu, confirmed that saponins in ginseng, combined with saponins in Siberian ginseng (notoginseng), do indeed decrease fasting blood glucose, improve glucose tolerance, and improves insulin and leptin sensitivity at a modest dosage over 12 to 30 days. NOTE: saponins are best extracted in alcohol and/or glycerin tincture:
  49. Studies in 2009 at the Department of Pharmacologie of the University of Montreal found that silibin from Milk Thistle effectively counters the type of fatty liver disease commonly seen as a progressive disorder in metabolic syndrome, obesity and diabetes, by exerting potent antioxidant and anti-inflammatory activities (reducing TNF-alpha), as well as improving insulin metabolism, and aiding liver function (hepatoprotective):
  50. Studies in 2014, at Huazhong University, and Zhengzhou University, in China, found that the Chinese herbal chemical resveratrol (from Polygonum cuspidatum) significantly improved insulin secretion and homeostasis over time by aiding pancreatic mitochondrial function and antioxidant effects:
  51. Studies in 2009 at the College of Pharmacy at Chungnam National University found that triterpenes in the Chinese herb Mud dan pi (Moutan cortex, or Paeonia suffruticosa) improved glucose uptake and glycogen synthesis in insulin-resistant liver cells, in a dose-dependant manner. NOTE: triterpenes are best extracted in an alcohol and glycerite tincture:
  52. Studies in 2010 at the Tajen University Department of Pharmacy in Taiwan found that the Chinese herb Abelmoschus moschatus, a type of hibiscus, was effective in improving insulin sensitivity with 2 weeks of use, and was useful as an integrative medicine for patients with insulin sensitivity:
  53. Studies at Shandong University and Ningxia Medical University, in China, found that a key polysaccharide chemical in the Chinese herb Lycium barbarum, Gou qi zi, or wolfberry, improved insulin resistance via antioxidant pathways, affecting the expression of Nrf2, JNK and glycogen synthase kinase 3 beta:
  54. Studies in 2013, at the University of Catania, in Catania, Italy, showed that bitter melon extract (Momordica foetida) may be useful in the prevention of Metabolic Syndrome by inhibiting lipid peroxidation:
  55. A 2010 study by the University of Athens, Greece, found that phytosterols in food and herbs are effective to reduce both small and dense LDL levels in Metabolic Syndrome, and also significantly improve cardiovascular risk factors:
  56. A meta-review of studies in 2008, at Louisiana State University, in Baton Rouge, Louisiana, U.S.A. showed that at that time, sound evidence supported the use of American Ginseng, Berberine from Chinese herbs, and Bitter Melon extract as part of the treatment protocol for Metabolic Syndrome, with the acknowledgement that more studies are needed to evaluate other Chinese herbs commonly used to treat Metabolic Syndrome:
  57. A study published in 2013, headed by Harvard Public Health, and conducted at a number of University Medical Schools, showed that just 8 ounces of fresh walnuts a month provided significant benefits in prevention of Diabetes Type 2 and Metabolic Syndrome, primarily due to the quality of omega-3 and omega-6 essential fatty acids, but also due to other nutrients:
  58. Studies in 2010 at the Chongqing Medical University in China found that electroacupuncture could significantly lower total cholesterol and triglyceride levels, acting in a similar fashion to the hypothalamic leptin stimulating effects noted with electroacupuncture. These effects were measure using just 2 points, ST40 and ST36:
  59. Studies in 2014, at the University of Gothenburg, Goteborg, Sweden, showed that a single treatment with electroacupuncture was proven to improve insulin sensitivity, affecting a variety of markers, including adiponectin, and expression of inflammatory markers such as ERK2:
  60. Controlled, randomized human clinical trials in 2010, at the University of Gothenburg, Goteborg, Sweden, showed that 16 weeks of treatment, once per week, with low frequency (2-5 Hz) electroacupuncture, significantly reduced the risk of thrombosis in women diagnosed with Metabolic Syndrome and Polycystic Ovarian Syndrome (PCOS). This study was limited to a simple electroacupuncture treatment, and measurement of cellular metabolics, and a more complete treatment protocol commonly used in the clinic may provide an array of benefits to treat Metabolic Syndrome, affecting other parameters of the disease: